National Provider Identifier [NPI]: |
1760611586 |
Last Name Of The Provider |
HOLMES |
First Name Of The Provider |
MEGAN |
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 |
10701 EAST BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
CLEVELAND |
Zip Code Of The Provider |
441061702 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
384 |
Number Of Medicare Beneficiaries |
285 |
Total Submitted Charge Amount |
69494 |
Total Medicare Allowed Amount |
27882.53 |
Total Medicare Payment Amount |
18473.32 |
Total Medicare Standardized Payment Amount |
18917.07 |
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 |
12 |
Number Of Medical Services |
384 |
Number Of Medicare Beneficiaries With Medical Services |
285 |
Total Medical Submitted Charge Amount |
69494 |
Total Medical Medicare Allowed Amount |
27882.53 |
Total Medical Medicare Payment Amount |
18473.32 |
Total Medical Medicare Standardized Payment Amount |
18917.07 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
163 |
Number Of Beneficiaries Age 65 to 74 |
101 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
157 |
Number Of Male Beneficiaries |
128 |
Number Of Non Hispanic White Beneficiaries |
157 |
Number Of Black or African American Beneficiaries |
61 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
53 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
107 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
178 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0879 |