National Provider Identifier [NPI]: |
1558343525 |
Last Name Of The Provider |
WHITTED |
First Name Of The Provider |
PETER |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D., J.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4353 DODGE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
OMAHA |
Zip Code Of The Provider |
681312709 |
State Code Of The Provider |
NE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
3188 |
Number Of Medicare Beneficiaries |
1655 |
Total Submitted Charge Amount |
774770 |
Total Medicare Allowed Amount |
374080.86 |
Total Medicare Payment Amount |
257192.38 |
Total Medicare Standardized Payment Amount |
283473.6 |
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 |
46 |
Number Of Medical Services |
3188 |
Number Of Medicare Beneficiaries With Medical Services |
1655 |
Total Medical Submitted Charge Amount |
774770 |
Total Medical Medicare Allowed Amount |
374080.86 |
Total Medical Medicare Payment Amount |
257192.38 |
Total Medical Medicare Standardized Payment Amount |
283473.6 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
43 |
Number Of Beneficiaries Age 65 to 74 |
669 |
Number Of Beneficiaries Age 75 to 84 |
640 |
Number Of Beneficiaries Age Greater 84 |
303 |
Number Of Female Beneficiaries |
1062 |
Number Of Male Beneficiaries |
593 |
Number Of Non Hispanic White Beneficiaries |
1567 |
Number Of Black or African American Beneficiaries |
42 |
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 |
26 |
Number Of Beneficiaries With Medicare Only Entitlement |
1581 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
74 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9161 |