National Provider Identifier [NPI]: |
1356696108 |
Last Name Of The Provider |
CASTLE |
First Name Of The Provider |
ADAM |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
OD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
29138 GRATIOT AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROSEVILLE |
Zip Code Of The Provider |
480664152 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
112 |
Number Of Medicare Beneficiaries |
101 |
Total Submitted Charge Amount |
12045 |
Total Medicare Allowed Amount |
11829.63 |
Total Medicare Payment Amount |
8613.83 |
Total Medicare Standardized Payment Amount |
8765.05 |
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 |
112 |
Number Of Medicare Beneficiaries With Medical Services |
101 |
Total Medical Submitted Charge Amount |
12045 |
Total Medical Medicare Allowed Amount |
11829.63 |
Total Medical Medicare Payment Amount |
8613.83 |
Total Medical Medicare Standardized Payment Amount |
8765.05 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
40 |
Number Of Beneficiaries Age 75 to 84 |
31 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
57 |
Number Of Male Beneficiaries |
44 |
Number Of Non Hispanic White Beneficiaries |
84 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
71 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
30 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
|
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3848 |