National Provider Identifier [NPI]: |
1497194112 |
Last Name Of The Provider |
IVERSON-HILL |
First Name Of The Provider |
SONJA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9801 DUPONT AVE S |
Street Address 2 Of The Provider |
SUITE 425 |
City Of The Provider |
BLOOMINGTON |
Zip Code Of The Provider |
554313100 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
945 |
Number Of Medicare Beneficiaries |
553 |
Total Submitted Charge Amount |
123203 |
Total Medicare Allowed Amount |
90117.52 |
Total Medicare Payment Amount |
58223.16 |
Total Medicare Standardized Payment Amount |
59119.94 |
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 |
22 |
Number Of Medical Services |
945 |
Number Of Medicare Beneficiaries With Medical Services |
553 |
Total Medical Submitted Charge Amount |
123203 |
Total Medical Medicare Allowed Amount |
90117.52 |
Total Medical Medicare Payment Amount |
58223.16 |
Total Medical Medicare Standardized Payment Amount |
59119.94 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
54 |
Number Of Beneficiaries Age 65 to 74 |
212 |
Number Of Beneficiaries Age 75 to 84 |
187 |
Number Of Beneficiaries Age Greater 84 |
100 |
Number Of Female Beneficiaries |
318 |
Number Of Male Beneficiaries |
235 |
Number Of Non Hispanic White Beneficiaries |
532 |
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 |
492 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
61 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
38 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9308 |