National Provider Identifier [NPI]: |
1255302287 |
Last Name Of The Provider |
PAUL |
First Name Of The Provider |
JONATHAN |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
111 COLCHESTER AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
BURLINGTON |
Zip Code Of The Provider |
054011473 |
State Code Of The Provider |
VT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
2128 |
Number Of Medicare Beneficiaries |
845 |
Total Submitted Charge Amount |
714069 |
Total Medicare Allowed Amount |
217077.07 |
Total Medicare Payment Amount |
158310.25 |
Total Medicare Standardized Payment Amount |
161881.77 |
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 |
33 |
Number Of Medical Services |
2128 |
Number Of Medicare Beneficiaries With Medical Services |
845 |
Total Medical Submitted Charge Amount |
714069 |
Total Medical Medicare Allowed Amount |
217077.07 |
Total Medical Medicare Payment Amount |
158310.25 |
Total Medical Medicare Standardized Payment Amount |
161881.77 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
131 |
Number Of Beneficiaries Age 65 to 74 |
348 |
Number Of Beneficiaries Age 75 to 84 |
246 |
Number Of Beneficiaries Age Greater 84 |
120 |
Number Of Female Beneficiaries |
493 |
Number Of Male Beneficiaries |
352 |
Number Of Non Hispanic White Beneficiaries |
790 |
Number Of Black or African American Beneficiaries |
12 |
Number Of AsianPacific Islander Beneficiaries |
13 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
19 |
Number Of Beneficiaries With Medicare Only Entitlement |
624 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
221 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1039 |