National Provider Identifier [NPI]: |
1043255086 |
Last Name Of The Provider |
SAWYER |
First Name Of The Provider |
JEFFREY |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
OD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
29 DIRIGO DRIVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
BREWER |
Zip Code Of The Provider |
044121600 |
State Code Of The Provider |
ME |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
3821 |
Number Of Medicare Beneficiaries |
610 |
Total Submitted Charge Amount |
173337 |
Total Medicare Allowed Amount |
115267.06 |
Total Medicare Payment Amount |
75622.69 |
Total Medicare Standardized Payment Amount |
82247.83 |
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 |
13 |
Number Of Medical Services |
3821 |
Number Of Medicare Beneficiaries With Medical Services |
610 |
Total Medical Submitted Charge Amount |
173337 |
Total Medical Medicare Allowed Amount |
115267.06 |
Total Medical Medicare Payment Amount |
75622.69 |
Total Medical Medicare Standardized Payment Amount |
82247.83 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
54 |
Number Of Beneficiaries Age 65 to 74 |
239 |
Number Of Beneficiaries Age 75 to 84 |
235 |
Number Of Beneficiaries Age Greater 84 |
82 |
Number Of Female Beneficiaries |
371 |
Number Of Male Beneficiaries |
239 |
Number Of Non Hispanic White Beneficiaries |
596 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
414 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
196 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0367 |