National Provider Identifier [NPI]: |
1497700983 |
Last Name Of The Provider |
LATONA |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1400 N RITTER AVE |
Street Address 2 Of The Provider |
STE 281 |
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462193052 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
3778 |
Number Of Medicare Beneficiaries |
1726 |
Total Submitted Charge Amount |
1551363 |
Total Medicare Allowed Amount |
456663.94 |
Total Medicare Payment Amount |
328895.75 |
Total Medicare Standardized Payment Amount |
350572.53 |
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 |
38 |
Number Of Medical Services |
3778 |
Number Of Medicare Beneficiaries With Medical Services |
1726 |
Total Medical Submitted Charge Amount |
1551363 |
Total Medical Medicare Allowed Amount |
456663.94 |
Total Medical Medicare Payment Amount |
328895.75 |
Total Medical Medicare Standardized Payment Amount |
350572.53 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
121 |
Number Of Beneficiaries Age 65 to 74 |
575 |
Number Of Beneficiaries Age 75 to 84 |
676 |
Number Of Beneficiaries Age Greater 84 |
354 |
Number Of Female Beneficiaries |
1090 |
Number Of Male Beneficiaries |
636 |
Number Of Non Hispanic White Beneficiaries |
1536 |
Number Of Black or African American Beneficiaries |
154 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1559 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
167 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1305 |