National Provider Identifier [NPI]: |
1235191198 |
Last Name Of The Provider |
HURST |
First Name Of The Provider |
MATTHEW |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
OD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
163 WEST HIGH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEW PHILADELPHIA |
Zip Code Of The Provider |
44663 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
240 |
Number Of Medicare Beneficiaries |
153 |
Total Submitted Charge Amount |
16361 |
Total Medicare Allowed Amount |
14790.15 |
Total Medicare Payment Amount |
10752.43 |
Total Medicare Standardized Payment Amount |
16239.78 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
14 |
Number Of Medical Services |
240 |
Number Of Medicare Beneficiaries With Medical Services |
153 |
Total Medical Submitted Charge Amount |
16361 |
Total Medical Medicare Allowed Amount |
14790.15 |
Total Medical Medicare Payment Amount |
10752.43 |
Total Medical Medicare Standardized Payment Amount |
16239.78 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
70 |
Number Of Beneficiaries Age 75 to 84 |
38 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
101 |
Number Of Male Beneficiaries |
52 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
117 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.072 |