National Provider Identifier [NPI]: |
1508931601 |
Last Name Of The Provider |
FAIN |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
323-325 NORTH MATHILDA AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SUNNYVALE |
Zip Code Of The Provider |
94085 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
969 |
Number Of Medicare Beneficiaries |
607 |
Total Submitted Charge Amount |
308607 |
Total Medicare Allowed Amount |
109631.64 |
Total Medicare Payment Amount |
76513.39 |
Total Medicare Standardized Payment Amount |
63340.63 |
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 |
16 |
Number Of Medical Services |
969 |
Number Of Medicare Beneficiaries With Medical Services |
607 |
Total Medical Submitted Charge Amount |
308607 |
Total Medical Medicare Allowed Amount |
109631.64 |
Total Medical Medicare Payment Amount |
76513.39 |
Total Medical Medicare Standardized Payment Amount |
63340.63 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
297 |
Number Of Beneficiaries Age 75 to 84 |
224 |
Number Of Beneficiaries Age Greater 84 |
60 |
Number Of Female Beneficiaries |
327 |
Number Of Male Beneficiaries |
280 |
Number Of Non Hispanic White Beneficiaries |
408 |
Number Of Black or African American Beneficiaries |
11 |
Number Of AsianPacific Islander Beneficiaries |
118 |
Number Of Hispanic Beneficiaries |
51 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
19 |
Number Of Beneficiaries With Medicare Only Entitlement |
507 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
100 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
4 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
23 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9464 |