National Provider Identifier [NPI]: |
1922088590 |
Last Name Of The Provider |
BRODSKY |
First Name Of The Provider |
LESLIE |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1 GRANITE POINT DR |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
WYOMISSING |
Zip Code Of The Provider |
196101986 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
852 |
Number Of Medicare Beneficiaries |
646 |
Total Submitted Charge Amount |
102860 |
Total Medicare Allowed Amount |
81883.91 |
Total Medicare Payment Amount |
54621.91 |
Total Medicare Standardized Payment Amount |
57704.44 |
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 |
16 |
Number Of Medical Services |
852 |
Number Of Medicare Beneficiaries With Medical Services |
646 |
Total Medical Submitted Charge Amount |
102860 |
Total Medical Medicare Allowed Amount |
81883.91 |
Total Medical Medicare Payment Amount |
54621.91 |
Total Medical Medicare Standardized Payment Amount |
57704.44 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
287 |
Number Of Beneficiaries Age 75 to 84 |
219 |
Number Of Beneficiaries Age Greater 84 |
110 |
Number Of Female Beneficiaries |
379 |
Number Of Male Beneficiaries |
267 |
Number Of Non Hispanic White Beneficiaries |
622 |
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 |
610 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9621 |