National Provider Identifier [NPI]: |
1366445819 |
Last Name Of The Provider |
NEAL |
First Name Of The Provider |
TERRY |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1045 N COURTENAY PARKWAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
MERRITT ISLAND |
Zip Code Of The Provider |
329534531 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
483 |
Number Of Medicare Beneficiaries |
303 |
Total Submitted Charge Amount |
54285 |
Total Medicare Allowed Amount |
45266.76 |
Total Medicare Payment Amount |
29990.41 |
Total Medicare Standardized Payment Amount |
31122.17 |
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 |
20 |
Number Of Medical Services |
483 |
Number Of Medicare Beneficiaries With Medical Services |
303 |
Total Medical Submitted Charge Amount |
54285 |
Total Medical Medicare Allowed Amount |
45266.76 |
Total Medical Medicare Payment Amount |
29990.41 |
Total Medical Medicare Standardized Payment Amount |
31122.17 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
63 |
Number Of Beneficiaries Age 65 to 74 |
125 |
Number Of Beneficiaries Age 75 to 84 |
81 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
172 |
Number Of Male Beneficiaries |
131 |
Number Of Non Hispanic White Beneficiaries |
224 |
Number Of Black or African American Beneficiaries |
54 |
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 |
78 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2002 |