National Provider Identifier [NPI]: |
1013070648 |
Last Name Of The Provider |
SWARTZ |
First Name Of The Provider |
BRENT |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2150 EWING CRAWFIS CIR |
Street Address 2 Of The Provider |
|
City Of The Provider |
BELLEFONTAINE |
Zip Code Of The Provider |
433119042 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
444 |
Number Of Medicare Beneficiaries |
136 |
Total Submitted Charge Amount |
23438.51 |
Total Medicare Allowed Amount |
21202.77 |
Total Medicare Payment Amount |
14161.64 |
Total Medicare Standardized Payment Amount |
15005.96 |
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 |
14 |
Number Of Medical Services |
444 |
Number Of Medicare Beneficiaries With Medical Services |
136 |
Total Medical Submitted Charge Amount |
23438.51 |
Total Medical Medicare Allowed Amount |
21202.77 |
Total Medical Medicare Payment Amount |
14161.64 |
Total Medical Medicare Standardized Payment Amount |
15005.96 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
63 |
Number Of Beneficiaries Age 75 to 84 |
48 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
76 |
Number Of Male Beneficiaries |
60 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
119 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
17 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9889 |