National Provider Identifier [NPI]: |
1548205172 |
Last Name Of The Provider |
CAZETT |
First Name Of The Provider |
MICHELLE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
OD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2802 S CENTER ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MARSHALLTOWN |
Zip Code Of The Provider |
50158 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
5 |
Number Of Services |
364 |
Number Of Medicare Beneficiaries |
294 |
Total Submitted Charge Amount |
22507 |
Total Medicare Allowed Amount |
21120.39 |
Total Medicare Payment Amount |
13906 |
Total Medicare Standardized Payment Amount |
22076.57 |
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 |
5 |
Number Of Medical Services |
364 |
Number Of Medicare Beneficiaries With Medical Services |
294 |
Total Medical Submitted Charge Amount |
22507 |
Total Medical Medicare Allowed Amount |
21120.39 |
Total Medical Medicare Payment Amount |
13906 |
Total Medical Medicare Standardized Payment Amount |
22076.57 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
159 |
Number Of Beneficiaries Age 75 to 84 |
92 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
172 |
Number Of Male Beneficiaries |
122 |
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 |
279 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
50 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
21 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8736 |