| National Provider Identifier [NPI]: | 1457309130 |
| Last Name Of The Provider | ODIN |
| First Name Of The Provider | LANNY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 500 N CHENEY ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | TAYLORVILLE |
| Zip Code Of The Provider | 625681139 |
| 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 | 39 |
| Number Of Services | 15983 |
| Number Of Medicare Beneficiaries | 1462 |
| Total Submitted Charge Amount | 3557521 |
| Total Medicare Allowed Amount | 2990079.01 |
| Total Medicare Payment Amount | 2298624.1 |
| Total Medicare Standardized Payment Amount | 2332385.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 3157 |
| Number Of Medicare Beneficiaries With Drug Services | 384 |
| Total Drug Submitted ChargeAmount | 2157345 |
| Total Drug Medicare AllowedAmount | 2018135.03 |
| Total Drug Medicare PaymentAmount | 1579097.87 |
| Total Drug Medicare Standardized Payment Amount | 1579097.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 12826 |
| Number Of Medicare Beneficiaries With Medical Services | 1462 |
| Total Medical Submitted Charge Amount | 1400176 |
| Total Medical Medicare Allowed Amount | 971943.98 |
| Total Medical Medicare Payment Amount | 719526.23 |
| Total Medical Medicare Standardized Payment Amount | 753287.18 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 103 |
| Number Of Beneficiaries Age 65 to 74 | 523 |
| Number Of Beneficiaries Age 75 to 84 | 495 |
| Number Of Beneficiaries Age Greater 84 | 341 |
| Number Of Female Beneficiaries | 859 |
| Number Of Male Beneficiaries | 603 |
| Number Of Non Hispanic White Beneficiaries | 1368 |
| Number Of Black or African American Beneficiaries | 49 |
| 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 | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1284 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 178 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4542 |