National Provider Identifier [NPI]: |
1932247962 |
Last Name Of The Provider |
LECLERE |
First Name Of The Provider |
JOSEPH |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
715 MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
TELL CITY |
Zip Code Of The Provider |
475861705 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
854 |
Number Of Medicare Beneficiaries |
477 |
Total Submitted Charge Amount |
83491.8 |
Total Medicare Allowed Amount |
75337.89 |
Total Medicare Payment Amount |
49678.3 |
Total Medicare Standardized Payment Amount |
59302.1 |
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 |
854 |
Number Of Medicare Beneficiaries With Medical Services |
477 |
Total Medical Submitted Charge Amount |
83491.8 |
Total Medical Medicare Allowed Amount |
75337.89 |
Total Medical Medicare Payment Amount |
49678.3 |
Total Medical Medicare Standardized Payment Amount |
59302.1 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
165 |
Number Of Beneficiaries Age 75 to 84 |
171 |
Number Of Beneficiaries Age Greater 84 |
104 |
Number Of Female Beneficiaries |
294 |
Number Of Male Beneficiaries |
183 |
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 |
409 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
68 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0077 |