National Provider Identifier [NPI]: |
1790862522 |
Last Name Of The Provider |
BIXENMAN |
First Name Of The Provider |
WAYNE |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1500 N WILMOT RD |
Street Address 2 Of The Provider |
SUITE 180C |
City Of The Provider |
TUCSON |
Zip Code Of The Provider |
85712 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
2569 |
Number Of Medicare Beneficiaries |
727 |
Total Submitted Charge Amount |
290440 |
Total Medicare Allowed Amount |
219833.18 |
Total Medicare Payment Amount |
157157.06 |
Total Medicare Standardized Payment Amount |
165555.08 |
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 |
23 |
Number Of Medical Services |
2569 |
Number Of Medicare Beneficiaries With Medical Services |
727 |
Total Medical Submitted Charge Amount |
290440 |
Total Medical Medicare Allowed Amount |
219833.18 |
Total Medical Medicare Payment Amount |
157157.06 |
Total Medical Medicare Standardized Payment Amount |
165555.08 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
326 |
Number Of Beneficiaries Age 75 to 84 |
257 |
Number Of Beneficiaries Age Greater 84 |
106 |
Number Of Female Beneficiaries |
411 |
Number Of Male Beneficiaries |
316 |
Number Of Non Hispanic White Beneficiaries |
663 |
Number Of Black or African American Beneficiaries |
12 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
33 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
707 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
20 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.0957 |