National Provider Identifier [NPI]: |
1508831074 |
Last Name Of The Provider |
DOTSON |
First Name Of The Provider |
DARRIN |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
302 UNIVERSITY BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROUND ROCK |
Zip Code Of The Provider |
786651032 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
864 |
Number Of Medicare Beneficiaries |
645 |
Total Submitted Charge Amount |
250707 |
Total Medicare Allowed Amount |
60987.28 |
Total Medicare Payment Amount |
43249.38 |
Total Medicare Standardized Payment Amount |
45316.24 |
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 |
864 |
Number Of Medicare Beneficiaries With Medical Services |
645 |
Total Medical Submitted Charge Amount |
250707 |
Total Medical Medicare Allowed Amount |
60987.28 |
Total Medical Medicare Payment Amount |
43249.38 |
Total Medical Medicare Standardized Payment Amount |
45316.24 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
71 |
Number Of Beneficiaries Age 65 to 74 |
305 |
Number Of Beneficiaries Age 75 to 84 |
207 |
Number Of Beneficiaries Age Greater 84 |
62 |
Number Of Female Beneficiaries |
371 |
Number Of Male Beneficiaries |
274 |
Number Of Non Hispanic White Beneficiaries |
543 |
Number Of Black or African American Beneficiaries |
37 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
48 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
576 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
69 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9707 |