National Provider Identifier [NPI]: |
1174670806 |
Last Name Of The Provider |
TO |
First Name Of The Provider |
KING |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
ONE HOPPIN STREET |
Street Address 2 Of The Provider |
SUITE 202 |
City Of The Provider |
PROVIDENCE |
Zip Code Of The Provider |
029034141 |
State Code Of The Provider |
RI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
2026 |
Number Of Medicare Beneficiaries |
665 |
Total Submitted Charge Amount |
499223 |
Total Medicare Allowed Amount |
225237.45 |
Total Medicare Payment Amount |
160611.59 |
Total Medicare Standardized Payment Amount |
156923 |
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 |
19 |
Number Of Medical Services |
2026 |
Number Of Medicare Beneficiaries With Medical Services |
665 |
Total Medical Submitted Charge Amount |
499223 |
Total Medical Medicare Allowed Amount |
225237.45 |
Total Medical Medicare Payment Amount |
160611.59 |
Total Medical Medicare Standardized Payment Amount |
156923 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
56 |
Number Of Beneficiaries Age 65 to 74 |
306 |
Number Of Beneficiaries Age 75 to 84 |
186 |
Number Of Beneficiaries Age Greater 84 |
117 |
Number Of Female Beneficiaries |
402 |
Number Of Male Beneficiaries |
263 |
Number Of Non Hispanic White Beneficiaries |
596 |
Number Of Black or African American Beneficiaries |
27 |
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
11 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
20 |
Number Of Beneficiaries With Medicare Only Entitlement |
610 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
55 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0591 |