National Provider Identifier [NPI]: |
1447203591 |
Last Name Of The Provider |
HOHENBARY |
First Name Of The Provider |
CHRISTY |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
OD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
903 MEDICAL PARK DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
EFFINGHAM |
Zip Code Of The Provider |
624012190 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
431 |
Number Of Medicare Beneficiaries |
308 |
Total Submitted Charge Amount |
47778.12 |
Total Medicare Allowed Amount |
34933.27 |
Total Medicare Payment Amount |
22604.44 |
Total Medicare Standardized Payment Amount |
24162.14 |
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 |
431 |
Number Of Medicare Beneficiaries With Medical Services |
308 |
Total Medical Submitted Charge Amount |
47778.12 |
Total Medical Medicare Allowed Amount |
34933.27 |
Total Medical Medicare Payment Amount |
22604.44 |
Total Medical Medicare Standardized Payment Amount |
24162.14 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
105 |
Number Of Beneficiaries Age 65 to 74 |
124 |
Number Of Beneficiaries Age 75 to 84 |
60 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
192 |
Number Of Male Beneficiaries |
116 |
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 |
190 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
118 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0462 |