National Provider Identifier [NPI]: |
1720186711 |
Last Name Of The Provider |
LOHSE |
First Name Of The Provider |
ERIC |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1025 S 6TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
627032403 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
1914 |
Number Of Medicare Beneficiaries |
786 |
Total Submitted Charge Amount |
314758.79 |
Total Medicare Allowed Amount |
273797.92 |
Total Medicare Payment Amount |
189960.32 |
Total Medicare Standardized Payment Amount |
201522.78 |
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 |
32 |
Number Of Medical Services |
1914 |
Number Of Medicare Beneficiaries With Medical Services |
786 |
Total Medical Submitted Charge Amount |
314758.79 |
Total Medical Medicare Allowed Amount |
273797.92 |
Total Medical Medicare Payment Amount |
189960.32 |
Total Medical Medicare Standardized Payment Amount |
201522.78 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
293 |
Number Of Beneficiaries Age 75 to 84 |
324 |
Number Of Beneficiaries Age Greater 84 |
152 |
Number Of Female Beneficiaries |
500 |
Number Of Male Beneficiaries |
286 |
Number Of Non Hispanic White Beneficiaries |
749 |
Number Of Black or African American Beneficiaries |
17 |
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 |
739 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
47 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
0.9853 |