National Provider Identifier [NPI]: |
1982677597 |
Last Name Of The Provider |
PODE |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
102 W ELM ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
STREATOR |
Zip Code Of The Provider |
613642127 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
3344 |
Number Of Medicare Beneficiaries |
1176 |
Total Submitted Charge Amount |
790360.5 |
Total Medicare Allowed Amount |
450013.39 |
Total Medicare Payment Amount |
323806.74 |
Total Medicare Standardized Payment Amount |
335274.81 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
138 |
Number Of Medicare Beneficiaries With Drug Services |
16 |
Total Drug Submitted ChargeAmount |
120950 |
Total Drug Medicare AllowedAmount |
44488.9 |
Total Drug Medicare PaymentAmount |
34597.3 |
Total Drug Medicare Standardized Payment Amount |
34597.3 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
50 |
Number Of Medical Services |
3206 |
Number Of Medicare Beneficiaries With Medical Services |
1176 |
Total Medical Submitted Charge Amount |
669410.5 |
Total Medical Medicare Allowed Amount |
405524.49 |
Total Medical Medicare Payment Amount |
289209.44 |
Total Medical Medicare Standardized Payment Amount |
300677.51 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
124 |
Number Of Beneficiaries Age 65 to 74 |
432 |
Number Of Beneficiaries Age 75 to 84 |
394 |
Number Of Beneficiaries Age Greater 84 |
226 |
Number Of Female Beneficiaries |
663 |
Number Of Male Beneficiaries |
513 |
Number Of Non Hispanic White Beneficiaries |
1099 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
58 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
953 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
223 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1844 |