National Provider Identifier [NPI]: |
1316903628 |
Last Name Of The Provider |
HEYDEN |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
OD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1025 REGENT ST |
Street Address 2 Of The Provider |
DAVIS DUEHR DEAN/DEAN MEDICAL CENTER |
City Of The Provider |
MADISON |
Zip Code Of The Provider |
537151248 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
4145 |
Number Of Medicare Beneficiaries |
505 |
Total Submitted Charge Amount |
355827 |
Total Medicare Allowed Amount |
59216.57 |
Total Medicare Payment Amount |
36394.27 |
Total Medicare Standardized Payment Amount |
39021.13 |
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 |
21 |
Number Of Medical Services |
4145 |
Number Of Medicare Beneficiaries With Medical Services |
505 |
Total Medical Submitted Charge Amount |
355827 |
Total Medical Medicare Allowed Amount |
59216.57 |
Total Medical Medicare Payment Amount |
36394.27 |
Total Medical Medicare Standardized Payment Amount |
39021.13 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
63 |
Number Of Beneficiaries Age 65 to 74 |
235 |
Number Of Beneficiaries Age 75 to 84 |
148 |
Number Of Beneficiaries Age Greater 84 |
59 |
Number Of Female Beneficiaries |
289 |
Number Of Male Beneficiaries |
216 |
Number Of Non Hispanic White Beneficiaries |
454 |
Number Of Black or African American Beneficiaries |
19 |
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 |
14 |
Number Of Beneficiaries With Medicare Only Entitlement |
428 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
77 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9463 |