National Provider Identifier [NPI]: |
1275708224 |
Last Name Of The Provider |
WILLIAMS |
First Name Of The Provider |
ALTON |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
100 CHRISTIANA MEDICAL CTR |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEWARK |
Zip Code Of The Provider |
197021697 |
State Code Of The Provider |
DE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
1076 |
Number Of Medicare Beneficiaries |
268 |
Total Submitted Charge Amount |
112430.22 |
Total Medicare Allowed Amount |
92677.97 |
Total Medicare Payment Amount |
64145.21 |
Total Medicare Standardized Payment Amount |
62966.34 |
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 |
17 |
Number Of Medical Services |
1076 |
Number Of Medicare Beneficiaries With Medical Services |
268 |
Total Medical Submitted Charge Amount |
112430.22 |
Total Medical Medicare Allowed Amount |
92677.97 |
Total Medical Medicare Payment Amount |
64145.21 |
Total Medical Medicare Standardized Payment Amount |
62966.34 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
137 |
Number Of Beneficiaries Age 75 to 84 |
86 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
177 |
Number Of Male Beneficiaries |
91 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
218 |
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 |
239 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
29 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.9747 |