National Provider Identifier [NPI]: |
1952657686 |
Last Name Of The Provider |
RICKEL |
First Name Of The Provider |
LUANN |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2489 TRAUTNER DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAGINAW |
Zip Code Of The Provider |
486049596 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
272 |
Number Of Medicare Beneficiaries |
203 |
Total Submitted Charge Amount |
57275 |
Total Medicare Allowed Amount |
27383.54 |
Total Medicare Payment Amount |
18503 |
Total Medicare Standardized Payment Amount |
19554.46 |
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 |
9 |
Number Of Medical Services |
272 |
Number Of Medicare Beneficiaries With Medical Services |
203 |
Total Medical Submitted Charge Amount |
57275 |
Total Medical Medicare Allowed Amount |
27383.54 |
Total Medical Medicare Payment Amount |
18503 |
Total Medical Medicare Standardized Payment Amount |
19554.46 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
82 |
Number Of Beneficiaries Age 75 to 84 |
69 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
111 |
Number Of Male Beneficiaries |
92 |
Number Of Non Hispanic White Beneficiaries |
144 |
Number Of Black or African American Beneficiaries |
43 |
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 |
174 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
29 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2109 |