National Provider Identifier [NPI]: |
1497732010 |
Last Name Of The Provider |
DANAHEY |
First Name Of The Provider |
KEVIN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
OD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
230 E DAY RD |
Street Address 2 Of The Provider |
100 |
City Of The Provider |
MISHAWAKA |
Zip Code Of The Provider |
465453408 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
1643 |
Number Of Medicare Beneficiaries |
717 |
Total Submitted Charge Amount |
160011 |
Total Medicare Allowed Amount |
137533.07 |
Total Medicare Payment Amount |
91167.45 |
Total Medicare Standardized Payment Amount |
98657.28 |
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 |
26 |
Number Of Medical Services |
1643 |
Number Of Medicare Beneficiaries With Medical Services |
717 |
Total Medical Submitted Charge Amount |
160011 |
Total Medical Medicare Allowed Amount |
137533.07 |
Total Medical Medicare Payment Amount |
91167.45 |
Total Medical Medicare Standardized Payment Amount |
98657.28 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
47 |
Number Of Beneficiaries Age 65 to 74 |
261 |
Number Of Beneficiaries Age 75 to 84 |
236 |
Number Of Beneficiaries Age Greater 84 |
173 |
Number Of Female Beneficiaries |
452 |
Number Of Male Beneficiaries |
265 |
Number Of Non Hispanic White Beneficiaries |
672 |
Number Of Black or African American Beneficiaries |
29 |
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 |
632 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
85 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0775 |