National Provider Identifier [NPI]: |
1588639371 |
Last Name Of The Provider |
MORRIS |
First Name Of The Provider |
TONY |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
OD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
905 7TH AVE. WEST |
Street Address 2 Of The Provider |
|
City Of The Provider |
DURAND |
Zip Code Of The Provider |
54736 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
3185 |
Number Of Medicare Beneficiaries |
329 |
Total Submitted Charge Amount |
32991 |
Total Medicare Allowed Amount |
30354.74 |
Total Medicare Payment Amount |
18320.83 |
Total Medicare Standardized Payment Amount |
32996.43 |
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 |
12 |
Number Of Medical Services |
3185 |
Number Of Medicare Beneficiaries With Medical Services |
329 |
Total Medical Submitted Charge Amount |
32991 |
Total Medical Medicare Allowed Amount |
30354.74 |
Total Medical Medicare Payment Amount |
18320.83 |
Total Medical Medicare Standardized Payment Amount |
32996.43 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
129 |
Number Of Beneficiaries Age 75 to 84 |
96 |
Number Of Beneficiaries Age Greater 84 |
60 |
Number Of Female Beneficiaries |
184 |
Number Of Male Beneficiaries |
145 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
225 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
104 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
38 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.167 |