National Provider Identifier [NPI]: |
1922038926 |
Last Name Of The Provider |
EGGIMANN |
First Name Of The Provider |
TIMOTHY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
OD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7920 OLD CEDAR AVE S |
Street Address 2 Of The Provider |
|
City Of The Provider |
BLOOMINGTON |
Zip Code Of The Provider |
554251207 |
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 |
14 |
Number Of Services |
332 |
Number Of Medicare Beneficiaries |
246 |
Total Submitted Charge Amount |
55248 |
Total Medicare Allowed Amount |
37140.35 |
Total Medicare Payment Amount |
24436.29 |
Total Medicare Standardized Payment Amount |
24780.25 |
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 |
14 |
Number Of Medical Services |
332 |
Number Of Medicare Beneficiaries With Medical Services |
246 |
Total Medical Submitted Charge Amount |
55248 |
Total Medical Medicare Allowed Amount |
37140.35 |
Total Medical Medicare Payment Amount |
24436.29 |
Total Medical Medicare Standardized Payment Amount |
24780.25 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
72 |
Number Of Beneficiaries Age 65 to 74 |
102 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
147 |
Number Of Male Beneficiaries |
99 |
Number Of Non Hispanic White Beneficiaries |
188 |
Number Of Black or African American Beneficiaries |
38 |
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 |
154 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
92 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
28 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
25 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1493 |