National Provider Identifier [NPI]: |
1609096478 |
Last Name Of The Provider |
SUMMERFIELD |
First Name Of The Provider |
MELISSA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3121 4TH ST SW |
Street Address 2 Of The Provider |
|
City Of The Provider |
MASON CITY |
Zip Code Of The Provider |
504011581 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
57 |
Number Of Services |
3299 |
Number Of Medicare Beneficiaries |
905 |
Total Submitted Charge Amount |
354896.17 |
Total Medicare Allowed Amount |
332931.04 |
Total Medicare Payment Amount |
244837.34 |
Total Medicare Standardized Payment Amount |
267020.95 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
81 |
Number Of Beneficiaries Age 65 to 74 |
414 |
Number Of Beneficiaries Age 75 to 84 |
274 |
Number Of Beneficiaries Age Greater 84 |
136 |
Number Of Female Beneficiaries |
534 |
Number Of Male Beneficiaries |
371 |
Number Of Non Hispanic White Beneficiaries |
872 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
788 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
117 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
38 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
1.0155 |