National Provider Identifier [NPI]: |
1710979794 |
Last Name Of The Provider |
GRIER |
First Name Of The Provider |
KENNETH |
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 |
8112 CENTRALIA CT SUITE# 102 |
Street Address 2 Of The Provider |
|
City Of The Provider |
LEESBURG |
Zip Code Of The Provider |
34788 |
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 |
8 |
Number Of Services |
580 |
Number Of Medicare Beneficiaries |
313 |
Total Submitted Charge Amount |
46739.96 |
Total Medicare Allowed Amount |
45909.38 |
Total Medicare Payment Amount |
31330.79 |
Total Medicare Standardized Payment Amount |
47910.52 |
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 |
8 |
Number Of Medical Services |
580 |
Number Of Medicare Beneficiaries With Medical Services |
313 |
Total Medical Submitted Charge Amount |
46739.96 |
Total Medical Medicare Allowed Amount |
45909.38 |
Total Medical Medicare Payment Amount |
31330.79 |
Total Medical Medicare Standardized Payment Amount |
47910.52 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
122 |
Number Of Beneficiaries Age 75 to 84 |
142 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
177 |
Number Of Male Beneficiaries |
136 |
Number Of Non Hispanic White Beneficiaries |
301 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
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 |
13 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0564 |