National Provider Identifier [NPI]: |
1225097009 |
Last Name Of The Provider |
JEFFRIES |
First Name Of The Provider |
AMY |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3150 HIGHWAY 34 E STE 306 |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEWNAN |
Zip Code Of The Provider |
302652123 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
848 |
Number Of Medicare Beneficiaries |
314 |
Total Submitted Charge Amount |
78117.51 |
Total Medicare Allowed Amount |
67123.59 |
Total Medicare Payment Amount |
46681.3 |
Total Medicare Standardized Payment Amount |
51049.27 |
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 |
18 |
Number Of Medical Services |
848 |
Number Of Medicare Beneficiaries With Medical Services |
314 |
Total Medical Submitted Charge Amount |
78117.51 |
Total Medical Medicare Allowed Amount |
67123.59 |
Total Medical Medicare Payment Amount |
46681.3 |
Total Medical Medicare Standardized Payment Amount |
51049.27 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
195 |
Number Of Beneficiaries Age 75 to 84 |
67 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
174 |
Number Of Male Beneficiaries |
140 |
Number Of Non Hispanic White Beneficiaries |
282 |
Number Of Black or African American Beneficiaries |
|
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 |
295 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
|
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
25 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.8465 |