National Provider Identifier [NPI]: |
1629045117 |
Last Name Of The Provider |
JEND |
First Name Of The Provider |
CELESTE |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
OD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
451 JUNCTION RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MADISON |
Zip Code Of The Provider |
53717 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
711 |
Number Of Medicare Beneficiaries |
561 |
Total Submitted Charge Amount |
132817.5 |
Total Medicare Allowed Amount |
58060.05 |
Total Medicare Payment Amount |
35214.29 |
Total Medicare Standardized Payment Amount |
37215.02 |
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 |
711 |
Number Of Medicare Beneficiaries With Medical Services |
561 |
Total Medical Submitted Charge Amount |
132817.5 |
Total Medical Medicare Allowed Amount |
58060.05 |
Total Medical Medicare Payment Amount |
35214.29 |
Total Medical Medicare Standardized Payment Amount |
37215.02 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
69 |
Number Of Beneficiaries Age 65 to 74 |
353 |
Number Of Beneficiaries Age 75 to 84 |
106 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
336 |
Number Of Male Beneficiaries |
225 |
Number Of Non Hispanic White Beneficiaries |
499 |
Number Of Black or African American Beneficiaries |
33 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
15 |
Number Of Beneficiaries With Medicare Only Entitlement |
491 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
70 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
4 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
47 |
Percent Of With Ischemic Heart Disease |
17 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8051 |