National Provider Identifier [NPI]: |
1679778245 |
Last Name Of The Provider |
DAI |
First Name Of The Provider |
ERIC |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5011 BURNET RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
AUSTIN |
Zip Code Of The Provider |
787562611 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
1676 |
Number Of Medicare Beneficiaries |
878 |
Total Submitted Charge Amount |
513522 |
Total Medicare Allowed Amount |
264574.75 |
Total Medicare Payment Amount |
188813.14 |
Total Medicare Standardized Payment Amount |
191366.05 |
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 |
28 |
Number Of Medical Services |
1676 |
Number Of Medicare Beneficiaries With Medical Services |
878 |
Total Medical Submitted Charge Amount |
513522 |
Total Medical Medicare Allowed Amount |
264574.75 |
Total Medical Medicare Payment Amount |
188813.14 |
Total Medical Medicare Standardized Payment Amount |
191366.05 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
423 |
Number Of Beneficiaries Age 75 to 84 |
248 |
Number Of Beneficiaries Age Greater 84 |
150 |
Number Of Female Beneficiaries |
515 |
Number Of Male Beneficiaries |
363 |
Number Of Non Hispanic White Beneficiaries |
725 |
Number Of Black or African American Beneficiaries |
49 |
Number Of AsianPacific Islander Beneficiaries |
21 |
Number Of Hispanic Beneficiaries |
71 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
12 |
Number Of Beneficiaries With Medicare Only Entitlement |
782 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
96 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.031 |