National Provider Identifier [NPI]: |
1124000831 |
Last Name Of The Provider |
KRAUEL |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1201 THOMASON LN |
Street Address 2 Of The Provider |
|
City Of The Provider |
ALTURAS |
Zip Code Of The Provider |
961013150 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
2039 |
Number Of Medicare Beneficiaries |
721 |
Total Submitted Charge Amount |
181231.43 |
Total Medicare Allowed Amount |
160031.06 |
Total Medicare Payment Amount |
105250.91 |
Total Medicare Standardized Payment Amount |
102740.89 |
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 |
31 |
Number Of Medical Services |
2039 |
Number Of Medicare Beneficiaries With Medical Services |
721 |
Total Medical Submitted Charge Amount |
181231.43 |
Total Medical Medicare Allowed Amount |
160031.06 |
Total Medical Medicare Payment Amount |
105250.91 |
Total Medical Medicare Standardized Payment Amount |
102740.89 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
41 |
Number Of Beneficiaries Age 65 to 74 |
334 |
Number Of Beneficiaries Age 75 to 84 |
248 |
Number Of Beneficiaries Age Greater 84 |
98 |
Number Of Female Beneficiaries |
410 |
Number Of Male Beneficiaries |
311 |
Number Of Non Hispanic White Beneficiaries |
662 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
20 |
Number Of American Indian Alaska Native Beneficiaries |
24 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
579 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
142 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
2 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
32 |
Percent Of With Hypertension |
48 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
2 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.8648 |