National Provider Identifier [NPI]: |
1598714321 |
Last Name Of The Provider |
LEIBSTEIN |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
116 BROADWAY |
Street Address 2 Of The Provider |
SUITE 2 |
City Of The Provider |
AMITYVILLE |
Zip Code Of The Provider |
117012797 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
844 |
Number Of Medicare Beneficiaries |
438 |
Total Submitted Charge Amount |
83890 |
Total Medicare Allowed Amount |
80995.07 |
Total Medicare Payment Amount |
61933.99 |
Total Medicare Standardized Payment Amount |
62503.74 |
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 |
16 |
Number Of Medical Services |
844 |
Number Of Medicare Beneficiaries With Medical Services |
438 |
Total Medical Submitted Charge Amount |
83890 |
Total Medical Medicare Allowed Amount |
80995.07 |
Total Medical Medicare Payment Amount |
61933.99 |
Total Medical Medicare Standardized Payment Amount |
62503.74 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
55 |
Number Of Beneficiaries Age 65 to 74 |
135 |
Number Of Beneficiaries Age 75 to 84 |
112 |
Number Of Beneficiaries Age Greater 84 |
136 |
Number Of Female Beneficiaries |
287 |
Number Of Male Beneficiaries |
151 |
Number Of Non Hispanic White Beneficiaries |
370 |
Number Of Black or African American Beneficiaries |
36 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
252 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
186 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
40 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.58 |