National Provider Identifier [NPI]: |
1699763227 |
Last Name Of The Provider |
CHIN |
First Name Of The Provider |
GREGORY |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
677 S JACKSON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SEATTLE |
Zip Code Of The Provider |
981042928 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
4321 |
Number Of Medicare Beneficiaries |
376 |
Total Submitted Charge Amount |
638196 |
Total Medicare Allowed Amount |
314625.67 |
Total Medicare Payment Amount |
231747.63 |
Total Medicare Standardized Payment Amount |
202610.5 |
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 |
19 |
Number Of Medical Services |
4321 |
Number Of Medicare Beneficiaries With Medical Services |
376 |
Total Medical Submitted Charge Amount |
638196 |
Total Medical Medicare Allowed Amount |
314625.67 |
Total Medical Medicare Payment Amount |
231747.63 |
Total Medical Medicare Standardized Payment Amount |
202610.5 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
135 |
Number Of Beneficiaries Age 75 to 84 |
150 |
Number Of Beneficiaries Age Greater 84 |
80 |
Number Of Female Beneficiaries |
239 |
Number Of Male Beneficiaries |
137 |
Number Of Non Hispanic White Beneficiaries |
61 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
261 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
23 |
Number Of Beneficiaries With Medicare Only Entitlement |
200 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
176 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
|
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
8 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
23 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9274 |