National Provider Identifier [NPI]: |
1578755229 |
Last Name Of The Provider |
NISBET |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3301 S ALAMEDA ST |
Street Address 2 Of The Provider |
#307 |
City Of The Provider |
CORPUS CHRISTI |
Zip Code Of The Provider |
784111882 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
4410 |
Number Of Medicare Beneficiaries |
764 |
Total Submitted Charge Amount |
618975 |
Total Medicare Allowed Amount |
356480.43 |
Total Medicare Payment Amount |
257736.91 |
Total Medicare Standardized Payment Amount |
284667.45 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
1007 |
Number Of Medicare Beneficiaries With Drug Services |
101 |
Total Drug Submitted ChargeAmount |
69780 |
Total Drug Medicare AllowedAmount |
51401.02 |
Total Drug Medicare PaymentAmount |
39894.83 |
Total Drug Medicare Standardized Payment Amount |
39894.83 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
14 |
Number Of Medical Services |
3403 |
Number Of Medicare Beneficiaries With Medical Services |
764 |
Total Medical Submitted Charge Amount |
549195 |
Total Medical Medicare Allowed Amount |
305079.41 |
Total Medical Medicare Payment Amount |
217842.08 |
Total Medical Medicare Standardized Payment Amount |
244772.62 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
244 |
Number Of Beneficiaries Age 75 to 84 |
303 |
Number Of Beneficiaries Age Greater 84 |
179 |
Number Of Female Beneficiaries |
456 |
Number Of Male Beneficiaries |
308 |
Number Of Non Hispanic White Beneficiaries |
589 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
159 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
703 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
61 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.3839 |