National Provider Identifier [NPI]: |
1043292295 |
Last Name Of The Provider |
AVILA |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5402 S STAPLES ST |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
CORPUS CHRISTI |
Zip Code Of The Provider |
784114656 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
596 |
Number Of Medicare Beneficiaries |
425 |
Total Submitted Charge Amount |
63962 |
Total Medicare Allowed Amount |
54280.18 |
Total Medicare Payment Amount |
35010.78 |
Total Medicare Standardized Payment Amount |
38116.87 |
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 |
10 |
Number Of Medical Services |
596 |
Number Of Medicare Beneficiaries With Medical Services |
425 |
Total Medical Submitted Charge Amount |
63962 |
Total Medical Medicare Allowed Amount |
54280.18 |
Total Medical Medicare Payment Amount |
35010.78 |
Total Medical Medicare Standardized Payment Amount |
38116.87 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
91 |
Number Of Beneficiaries Age 65 to 74 |
169 |
Number Of Beneficiaries Age 75 to 84 |
105 |
Number Of Beneficiaries Age Greater 84 |
60 |
Number Of Female Beneficiaries |
270 |
Number Of Male Beneficiaries |
155 |
Number Of Non Hispanic White Beneficiaries |
150 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
248 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
269 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
156 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.3809 |