National Provider Identifier [NPI]: |
1154339000 |
Last Name Of The Provider |
GARMIZO |
First Name Of The Provider |
GUSTAVO |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
OD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7822 N UNIVERSITY DRIVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
TAMARAC |
Zip Code Of The Provider |
333212114 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
789 |
Number Of Medicare Beneficiaries |
247 |
Total Submitted Charge Amount |
70277 |
Total Medicare Allowed Amount |
63039.61 |
Total Medicare Payment Amount |
45384.2 |
Total Medicare Standardized Payment Amount |
45440.3 |
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 |
34 |
Number Of Medical Services |
789 |
Number Of Medicare Beneficiaries With Medical Services |
247 |
Total Medical Submitted Charge Amount |
70277 |
Total Medical Medicare Allowed Amount |
63039.61 |
Total Medical Medicare Payment Amount |
45384.2 |
Total Medical Medicare Standardized Payment Amount |
45440.3 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
91 |
Number Of Beneficiaries Age 75 to 84 |
88 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
160 |
Number Of Male Beneficiaries |
87 |
Number Of Non Hispanic White Beneficiaries |
216 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
20 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1541 |