National Provider Identifier [NPI]: |
1346241015 |
Last Name Of The Provider |
FITZHUGH |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
210 THOMAS ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
STAMPS |
Zip Code Of The Provider |
718602848 |
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 |
14 |
Number Of Services |
2363 |
Number Of Medicare Beneficiaries |
640 |
Total Submitted Charge Amount |
173203 |
Total Medicare Allowed Amount |
140360.61 |
Total Medicare Payment Amount |
92948.48 |
Total Medicare Standardized Payment Amount |
112133.91 |
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 |
14 |
Number Of Medical Services |
2363 |
Number Of Medicare Beneficiaries With Medical Services |
640 |
Total Medical Submitted Charge Amount |
173203 |
Total Medical Medicare Allowed Amount |
140360.61 |
Total Medical Medicare Payment Amount |
92948.48 |
Total Medical Medicare Standardized Payment Amount |
112133.91 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
102 |
Number Of Beneficiaries Age 65 to 74 |
238 |
Number Of Beneficiaries Age 75 to 84 |
225 |
Number Of Beneficiaries Age Greater 84 |
75 |
Number Of Female Beneficiaries |
395 |
Number Of Male Beneficiaries |
245 |
Number Of Non Hispanic White Beneficiaries |
422 |
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 |
447 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
193 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0232 |