National Provider Identifier [NPI]: |
1417997420 |
Last Name Of The Provider |
GILBERT |
First Name Of The Provider |
LOWELL |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
OD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3731 A BOULEVARD |
Street Address 2 Of The Provider |
|
City Of The Provider |
COLONIAL HEIGHTS |
Zip Code Of The Provider |
23834 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
4959 |
Number Of Medicare Beneficiaries |
506 |
Total Submitted Charge Amount |
136897.36 |
Total Medicare Allowed Amount |
112669.83 |
Total Medicare Payment Amount |
79891.88 |
Total Medicare Standardized Payment Amount |
88463.51 |
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 |
17 |
Number Of Medical Services |
4959 |
Number Of Medicare Beneficiaries With Medical Services |
506 |
Total Medical Submitted Charge Amount |
136897.36 |
Total Medical Medicare Allowed Amount |
112669.83 |
Total Medical Medicare Payment Amount |
79891.88 |
Total Medical Medicare Standardized Payment Amount |
88463.51 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
25 |
Number Of Beneficiaries Age 65 to 74 |
221 |
Number Of Beneficiaries Age 75 to 84 |
187 |
Number Of Beneficiaries Age Greater 84 |
73 |
Number Of Female Beneficiaries |
314 |
Number Of Male Beneficiaries |
192 |
Number Of Non Hispanic White Beneficiaries |
435 |
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 |
470 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9439 |