National Provider Identifier [NPI]: |
1104838994 |
Last Name Of The Provider |
HARRIS |
First Name Of The Provider |
CHRISTOPHER |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3100 WOOSTER ROAD |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROCKY RIVER |
Zip Code Of The Provider |
44116 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
2120.1 |
Number Of Medicare Beneficiaries |
728 |
Total Submitted Charge Amount |
262715 |
Total Medicare Allowed Amount |
203719.44 |
Total Medicare Payment Amount |
137840.26 |
Total Medicare Standardized Payment Amount |
144555.61 |
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 |
23 |
Number Of Medical Services |
2120.1 |
Number Of Medicare Beneficiaries With Medical Services |
728 |
Total Medical Submitted Charge Amount |
262715 |
Total Medical Medicare Allowed Amount |
203719.44 |
Total Medical Medicare Payment Amount |
137840.26 |
Total Medical Medicare Standardized Payment Amount |
144555.61 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
240 |
Number Of Beneficiaries Age 75 to 84 |
284 |
Number Of Beneficiaries Age Greater 84 |
187 |
Number Of Female Beneficiaries |
459 |
Number Of Male Beneficiaries |
269 |
Number Of Non Hispanic White Beneficiaries |
706 |
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 |
700 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0313 |