National Provider Identifier [NPI]: |
1407895949 |
Last Name Of The Provider |
CHAMBERLAIN |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4315 DIPLOMACY DR |
Street Address 2 Of The Provider |
ATTN: SHERRY REEDY |
City Of The Provider |
ANCHORAGE |
Zip Code Of The Provider |
995085926 |
State Code Of The Provider |
AK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
542 |
Number Of Medicare Beneficiaries |
252 |
Total Submitted Charge Amount |
957895.46 |
Total Medicare Allowed Amount |
139161.09 |
Total Medicare Payment Amount |
103927.61 |
Total Medicare Standardized Payment Amount |
82449.06 |
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 |
26 |
Number Of Medical Services |
542 |
Number Of Medicare Beneficiaries With Medical Services |
252 |
Total Medical Submitted Charge Amount |
957895.46 |
Total Medical Medicare Allowed Amount |
139161.09 |
Total Medical Medicare Payment Amount |
103927.61 |
Total Medical Medicare Standardized Payment Amount |
82449.06 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
119 |
Number Of Beneficiaries Age 75 to 84 |
87 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
151 |
Number Of Male Beneficiaries |
101 |
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 |
151 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
101 |
Percent Of With Atrial Fibrillation |
4 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
23 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.971 |