National Provider Identifier [NPI]: |
1164478905 |
Last Name Of The Provider |
JONES |
First Name Of The Provider |
RAYMOND |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
OD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8025 DOLLARWAY RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
WHITE HALL |
Zip Code Of The Provider |
71602 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
539 |
Number Of Medicare Beneficiaries |
412 |
Total Submitted Charge Amount |
40415 |
Total Medicare Allowed Amount |
37309.99 |
Total Medicare Payment Amount |
24841.92 |
Total Medicare Standardized Payment Amount |
42761.82 |
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 |
13 |
Number Of Medical Services |
539 |
Number Of Medicare Beneficiaries With Medical Services |
412 |
Total Medical Submitted Charge Amount |
40415 |
Total Medical Medicare Allowed Amount |
37309.99 |
Total Medical Medicare Payment Amount |
24841.92 |
Total Medical Medicare Standardized Payment Amount |
42761.82 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
182 |
Number Of Beneficiaries Age 75 to 84 |
141 |
Number Of Beneficiaries Age Greater 84 |
50 |
Number Of Female Beneficiaries |
261 |
Number Of Male Beneficiaries |
151 |
Number Of Non Hispanic White Beneficiaries |
386 |
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 |
364 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
48 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.9921 |