National Provider Identifier [NPI]: |
1578551735 |
Last Name Of The Provider |
POOLE |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
OD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
201 W SOUTH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
UNION |
Zip Code Of The Provider |
293792836 |
State Code Of The Provider |
SC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
689 |
Number Of Medicare Beneficiaries |
500 |
Total Submitted Charge Amount |
64355 |
Total Medicare Allowed Amount |
57728.86 |
Total Medicare Payment Amount |
37777.11 |
Total Medicare Standardized Payment Amount |
48578.82 |
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 |
689 |
Number Of Medicare Beneficiaries With Medical Services |
500 |
Total Medical Submitted Charge Amount |
64355 |
Total Medical Medicare Allowed Amount |
57728.86 |
Total Medical Medicare Payment Amount |
37777.11 |
Total Medical Medicare Standardized Payment Amount |
48578.82 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
92 |
Number Of Beneficiaries Age 65 to 74 |
192 |
Number Of Beneficiaries Age 75 to 84 |
164 |
Number Of Beneficiaries Age Greater 84 |
52 |
Number Of Female Beneficiaries |
345 |
Number Of Male Beneficiaries |
155 |
Number Of Non Hispanic White Beneficiaries |
409 |
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 |
394 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
106 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1427 |