National Provider Identifier [NPI]: |
1184628091 |
Last Name Of The Provider |
GRAF |
First Name Of The Provider |
JEFFERY |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
OD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
754 S MAIN ST |
Street Address 2 Of The Provider |
STE 6 |
City Of The Provider |
SAINT GEORGE |
Zip Code Of The Provider |
847705504 |
State Code Of The Provider |
UT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
2101 |
Number Of Medicare Beneficiaries |
358 |
Total Submitted Charge Amount |
251541 |
Total Medicare Allowed Amount |
171941.09 |
Total Medicare Payment Amount |
120894.92 |
Total Medicare Standardized Payment Amount |
128344.7 |
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 |
18 |
Number Of Medical Services |
2101 |
Number Of Medicare Beneficiaries With Medical Services |
358 |
Total Medical Submitted Charge Amount |
251541 |
Total Medical Medicare Allowed Amount |
171941.09 |
Total Medical Medicare Payment Amount |
120894.92 |
Total Medical Medicare Standardized Payment Amount |
128344.7 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
151 |
Number Of Beneficiaries Age 75 to 84 |
134 |
Number Of Beneficiaries Age Greater 84 |
61 |
Number Of Female Beneficiaries |
206 |
Number Of Male Beneficiaries |
152 |
Number Of Non Hispanic White Beneficiaries |
345 |
Number Of Black or African American Beneficiaries |
0 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
347 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
11 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
50 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0072 |