National Provider Identifier [NPI]: |
1619002243 |
Last Name Of The Provider |
PRELL |
First Name Of The Provider |
JOE |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
251 2ND ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
REEDSBURG |
Zip Code Of The Provider |
539591610 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
1122 |
Number Of Medicare Beneficiaries |
226 |
Total Submitted Charge Amount |
41612.5 |
Total Medicare Allowed Amount |
36280.8 |
Total Medicare Payment Amount |
21704.09 |
Total Medicare Standardized Payment Amount |
26359.41 |
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 |
1122 |
Number Of Medicare Beneficiaries With Medical Services |
226 |
Total Medical Submitted Charge Amount |
41612.5 |
Total Medical Medicare Allowed Amount |
36280.8 |
Total Medical Medicare Payment Amount |
21704.09 |
Total Medical Medicare Standardized Payment Amount |
26359.41 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
42 |
Number Of Beneficiaries Age 65 to 74 |
82 |
Number Of Beneficiaries Age 75 to 84 |
69 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
153 |
Number Of Male Beneficiaries |
73 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
149 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
77 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
|
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
46 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0451 |