National Provider Identifier [NPI]: |
1083643407 |
Last Name Of The Provider |
MEYER |
First Name Of The Provider |
LARRY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2253 W MASON ST |
Street Address 2 Of The Provider |
STE 100 |
City Of The Provider |
GREEN BAY |
Zip Code Of The Provider |
543034706 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
1481 |
Number Of Medicare Beneficiaries |
623 |
Total Submitted Charge Amount |
1089255.4 |
Total Medicare Allowed Amount |
235156.11 |
Total Medicare Payment Amount |
167268.09 |
Total Medicare Standardized Payment Amount |
174916.3 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
249 |
Number Of Beneficiaries Age 75 to 84 |
237 |
Number Of Beneficiaries Age Greater 84 |
100 |
Number Of Female Beneficiaries |
384 |
Number Of Male Beneficiaries |
239 |
Number Of Non Hispanic White Beneficiaries |
607 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
576 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
47 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9411 |