National Provider Identifier [NPI]: |
1467412601 |
Last Name Of The Provider |
CAMERON |
First Name Of The Provider |
LINDA |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
56 FRANKLIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
RUMFORD |
Zip Code Of The Provider |
042762060 |
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 |
19 |
Number Of Services |
4278 |
Number Of Medicare Beneficiaries |
493 |
Total Submitted Charge Amount |
115718 |
Total Medicare Allowed Amount |
94954.3 |
Total Medicare Payment Amount |
60273.23 |
Total Medicare Standardized Payment Amount |
65731.87 |
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 |
19 |
Number Of Medical Services |
4278 |
Number Of Medicare Beneficiaries With Medical Services |
493 |
Total Medical Submitted Charge Amount |
115718 |
Total Medical Medicare Allowed Amount |
94954.3 |
Total Medical Medicare Payment Amount |
60273.23 |
Total Medical Medicare Standardized Payment Amount |
65731.87 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
53 |
Number Of Beneficiaries Age 65 to 74 |
164 |
Number Of Beneficiaries Age 75 to 84 |
197 |
Number Of Beneficiaries Age Greater 84 |
79 |
Number Of Female Beneficiaries |
338 |
Number Of Male Beneficiaries |
155 |
Number Of Non Hispanic White Beneficiaries |
480 |
Number Of Black or African American Beneficiaries |
0 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
355 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
138 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.991 |