National Provider Identifier [NPI]: |
1467563312 |
Last Name Of The Provider |
SOHN |
First Name Of The Provider |
ELLIOTT |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 HAWKINS DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
IOWA CITY |
Zip Code Of The Provider |
522421007 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
2435 |
Number Of Medicare Beneficiaries |
495 |
Total Submitted Charge Amount |
721061.5 |
Total Medicare Allowed Amount |
178753.09 |
Total Medicare Payment Amount |
133664.72 |
Total Medicare Standardized Payment Amount |
141524.58 |
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 |
36 |
Number Of Medical Services |
2435 |
Number Of Medicare Beneficiaries With Medical Services |
495 |
Total Medical Submitted Charge Amount |
721061.5 |
Total Medical Medicare Allowed Amount |
178753.09 |
Total Medical Medicare Payment Amount |
133664.72 |
Total Medical Medicare Standardized Payment Amount |
141524.58 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
69 |
Number Of Beneficiaries Age 65 to 74 |
194 |
Number Of Beneficiaries Age 75 to 84 |
142 |
Number Of Beneficiaries Age Greater 84 |
90 |
Number Of Female Beneficiaries |
264 |
Number Of Male Beneficiaries |
231 |
Number Of Non Hispanic White Beneficiaries |
456 |
Number Of Black or African American Beneficiaries |
14 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
418 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
77 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.3696 |