National Provider Identifier [NPI]: |
1417067810 |
Last Name Of The Provider |
THOMPSON |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10666 N TORREY PINES RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LA JOLLA |
Zip Code Of The Provider |
920371027 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
759 |
Number Of Medicare Beneficiaries |
650 |
Total Submitted Charge Amount |
154644 |
Total Medicare Allowed Amount |
91086.87 |
Total Medicare Payment Amount |
58711.4 |
Total Medicare Standardized Payment Amount |
56655.67 |
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 |
17 |
Number Of Medical Services |
759 |
Number Of Medicare Beneficiaries With Medical Services |
650 |
Total Medical Submitted Charge Amount |
154644 |
Total Medical Medicare Allowed Amount |
91086.87 |
Total Medical Medicare Payment Amount |
58711.4 |
Total Medical Medicare Standardized Payment Amount |
56655.67 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
323 |
Number Of Beneficiaries Age 75 to 84 |
219 |
Number Of Beneficiaries Age Greater 84 |
87 |
Number Of Female Beneficiaries |
380 |
Number Of Male Beneficiaries |
270 |
Number Of Non Hispanic White Beneficiaries |
573 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
25 |
Number Of Hispanic Beneficiaries |
25 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
604 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
46 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
48 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9398 |