National Provider Identifier [NPI]: |
1679542633 |
Last Name Of The Provider |
DURYEA |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1555 BRADY ROAD |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHESANING |
Zip Code Of The Provider |
486160355 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
1800 |
Number Of Medicare Beneficiaries |
822 |
Total Submitted Charge Amount |
210850 |
Total Medicare Allowed Amount |
180551.62 |
Total Medicare Payment Amount |
124738.12 |
Total Medicare Standardized Payment Amount |
134445.86 |
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 |
24 |
Number Of Medical Services |
1800 |
Number Of Medicare Beneficiaries With Medical Services |
822 |
Total Medical Submitted Charge Amount |
210850 |
Total Medical Medicare Allowed Amount |
180551.62 |
Total Medical Medicare Payment Amount |
124738.12 |
Total Medical Medicare Standardized Payment Amount |
134445.86 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
126 |
Number Of Beneficiaries Age 65 to 74 |
355 |
Number Of Beneficiaries Age 75 to 84 |
267 |
Number Of Beneficiaries Age Greater 84 |
74 |
Number Of Female Beneficiaries |
476 |
Number Of Male Beneficiaries |
346 |
Number Of Non Hispanic White Beneficiaries |
795 |
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 |
693 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
129 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0391 |