National Provider Identifier [NPI]: |
1386873917 |
Last Name Of The Provider |
JAMES |
First Name Of The Provider |
CHARLENE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8231 BRIER CREEK PKWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
RALEIGH |
Zip Code Of The Provider |
276177705 |
State Code Of The Provider |
NC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
1304 |
Number Of Medicare Beneficiaries |
791 |
Total Submitted Charge Amount |
155483.14 |
Total Medicare Allowed Amount |
121629.5 |
Total Medicare Payment Amount |
77632.98 |
Total Medicare Standardized Payment Amount |
83500.3 |
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 |
19 |
Number Of Medical Services |
1304 |
Number Of Medicare Beneficiaries With Medical Services |
791 |
Total Medical Submitted Charge Amount |
155483.14 |
Total Medical Medicare Allowed Amount |
121629.5 |
Total Medical Medicare Payment Amount |
77632.98 |
Total Medical Medicare Standardized Payment Amount |
83500.3 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
52 |
Number Of Beneficiaries Age 65 to 74 |
242 |
Number Of Beneficiaries Age 75 to 84 |
304 |
Number Of Beneficiaries Age Greater 84 |
193 |
Number Of Female Beneficiaries |
492 |
Number Of Male Beneficiaries |
299 |
Number Of Non Hispanic White Beneficiaries |
761 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
694 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
97 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0058 |