National Provider Identifier [NPI]: |
1083693220 |
Last Name Of The Provider |
YOULDEN |
First Name Of The Provider |
ERIC |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
404 W FOUNTAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ALBERT LEA |
Zip Code Of The Provider |
560072437 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
2056 |
Number Of Medicare Beneficiaries |
442 |
Total Submitted Charge Amount |
154251.95 |
Total Medicare Allowed Amount |
45033.3 |
Total Medicare Payment Amount |
28951.37 |
Total Medicare Standardized Payment Amount |
30104.2 |
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 |
25 |
Number Of Medical Services |
2056 |
Number Of Medicare Beneficiaries With Medical Services |
442 |
Total Medical Submitted Charge Amount |
154251.95 |
Total Medical Medicare Allowed Amount |
45033.3 |
Total Medical Medicare Payment Amount |
28951.37 |
Total Medical Medicare Standardized Payment Amount |
30104.2 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
51 |
Number Of Beneficiaries Age 65 to 74 |
146 |
Number Of Beneficiaries Age 75 to 84 |
153 |
Number Of Beneficiaries Age Greater 84 |
92 |
Number Of Female Beneficiaries |
248 |
Number Of Male Beneficiaries |
194 |
Number Of Non Hispanic White Beneficiaries |
416 |
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 |
346 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
96 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.9974 |