National Provider Identifier [NPI]: |
1639165640 |
Last Name Of The Provider |
CALAWAY |
First Name Of The Provider |
CHRIS |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
31 CONSERVATORY DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
BARBERTON |
Zip Code Of The Provider |
442034281 |
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 |
20 |
Number Of Services |
4199 |
Number Of Medicare Beneficiaries |
527 |
Total Submitted Charge Amount |
101300 |
Total Medicare Allowed Amount |
95219.5 |
Total Medicare Payment Amount |
63946.45 |
Total Medicare Standardized Payment Amount |
68080.03 |
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 |
20 |
Number Of Medical Services |
4199 |
Number Of Medicare Beneficiaries With Medical Services |
527 |
Total Medical Submitted Charge Amount |
101300 |
Total Medical Medicare Allowed Amount |
95219.5 |
Total Medical Medicare Payment Amount |
63946.45 |
Total Medical Medicare Standardized Payment Amount |
68080.03 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
35 |
Number Of Beneficiaries Age 65 to 74 |
223 |
Number Of Beneficiaries Age 75 to 84 |
153 |
Number Of Beneficiaries Age Greater 84 |
116 |
Number Of Female Beneficiaries |
320 |
Number Of Male Beneficiaries |
207 |
Number Of Non Hispanic White Beneficiaries |
505 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
485 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
42 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1386 |