National Provider Identifier [NPI]: |
1427069806 |
Last Name Of The Provider |
FREEMAN |
First Name Of The Provider |
KEVIN |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
33 UPPER RIVERDALE RD SW |
Street Address 2 Of The Provider |
SUITE 114 |
City Of The Provider |
RIVERDALE |
Zip Code Of The Provider |
302742626 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
2674 |
Number Of Medicare Beneficiaries |
893 |
Total Submitted Charge Amount |
1128120 |
Total Medicare Allowed Amount |
428094.73 |
Total Medicare Payment Amount |
319440.9 |
Total Medicare Standardized Payment Amount |
319562.26 |
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 |
25 |
Number Of Medical Services |
2674 |
Number Of Medicare Beneficiaries With Medical Services |
893 |
Total Medical Submitted Charge Amount |
1128120 |
Total Medical Medicare Allowed Amount |
428094.73 |
Total Medical Medicare Payment Amount |
319440.9 |
Total Medical Medicare Standardized Payment Amount |
319562.26 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
107 |
Number Of Beneficiaries Age 65 to 74 |
423 |
Number Of Beneficiaries Age 75 to 84 |
287 |
Number Of Beneficiaries Age Greater 84 |
76 |
Number Of Female Beneficiaries |
556 |
Number Of Male Beneficiaries |
337 |
Number Of Non Hispanic White Beneficiaries |
486 |
Number Of Black or African American Beneficiaries |
338 |
Number Of AsianPacific Islander Beneficiaries |
34 |
Number Of Hispanic Beneficiaries |
23 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
731 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
162 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.1856 |