National Provider Identifier [NPI]: |
1821016981 |
Last Name Of The Provider |
CARLSON |
First Name Of The Provider |
JULIE |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1211 S ARLINGTON HEIGHTS RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
ARLINGTON HEIGHTS |
Zip Code Of The Provider |
600053142 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
783 |
Number Of Medicare Beneficiaries |
362 |
Total Submitted Charge Amount |
69993.34 |
Total Medicare Allowed Amount |
69479.96 |
Total Medicare Payment Amount |
45951.91 |
Total Medicare Standardized Payment Amount |
43245.99 |
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 |
13 |
Number Of Medical Services |
783 |
Number Of Medicare Beneficiaries With Medical Services |
362 |
Total Medical Submitted Charge Amount |
69993.34 |
Total Medical Medicare Allowed Amount |
69479.96 |
Total Medical Medicare Payment Amount |
45951.91 |
Total Medical Medicare Standardized Payment Amount |
43245.99 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
167 |
Number Of Beneficiaries Age 75 to 84 |
134 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
227 |
Number Of Male Beneficiaries |
135 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.8466 |