National Provider Identifier [NPI]: |
1396701421 |
Last Name Of The Provider |
BRYANT |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
OD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1100 MOCKINGBIRD LN |
Street Address 2 Of The Provider |
|
City Of The Provider |
SULPHUR SPRINGS |
Zip Code Of The Provider |
754824853 |
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 |
24 |
Number Of Services |
1803 |
Number Of Medicare Beneficiaries |
1019 |
Total Submitted Charge Amount |
218389.41 |
Total Medicare Allowed Amount |
173984.37 |
Total Medicare Payment Amount |
112961.25 |
Total Medicare Standardized Payment Amount |
119137.52 |
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 |
24 |
Number Of Medical Services |
1803 |
Number Of Medicare Beneficiaries With Medical Services |
1019 |
Total Medical Submitted Charge Amount |
218389.41 |
Total Medical Medicare Allowed Amount |
173984.37 |
Total Medical Medicare Payment Amount |
112961.25 |
Total Medical Medicare Standardized Payment Amount |
119137.52 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
452 |
Number Of Beneficiaries Age 75 to 84 |
389 |
Number Of Beneficiaries Age Greater 84 |
147 |
Number Of Female Beneficiaries |
652 |
Number Of Male Beneficiaries |
367 |
Number Of Non Hispanic White Beneficiaries |
970 |
Number Of Black or African American Beneficiaries |
26 |
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 |
954 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
65 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.8906 |