National Provider Identifier [NPI]: |
1568454320 |
Last Name Of The Provider |
LEACH |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3000 W DR MARTIN LUTHER KING JR BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
TAMPA |
Zip Code Of The Provider |
336076308 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
2788 |
Number Of Medicare Beneficiaries |
1015 |
Total Submitted Charge Amount |
1087697.26 |
Total Medicare Allowed Amount |
480063.44 |
Total Medicare Payment Amount |
354496.22 |
Total Medicare Standardized Payment Amount |
359301.06 |
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 |
28 |
Number Of Medical Services |
2788 |
Number Of Medicare Beneficiaries With Medical Services |
1015 |
Total Medical Submitted Charge Amount |
1087697.26 |
Total Medical Medicare Allowed Amount |
480063.44 |
Total Medical Medicare Payment Amount |
354496.22 |
Total Medical Medicare Standardized Payment Amount |
359301.06 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
48 |
Number Of Beneficiaries Age 65 to 74 |
486 |
Number Of Beneficiaries Age 75 to 84 |
337 |
Number Of Beneficiaries Age Greater 84 |
144 |
Number Of Female Beneficiaries |
631 |
Number Of Male Beneficiaries |
384 |
Number Of Non Hispanic White Beneficiaries |
796 |
Number Of Black or African American Beneficiaries |
64 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
139 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
935 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
80 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.0823 |