National Provider Identifier [NPI]: |
1619933363 |
Last Name Of The Provider |
ATODARIA |
First Name Of The Provider |
NEIL |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4800 N 22ND ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
PHOENIX |
Zip Code Of The Provider |
850164701 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
4983 |
Number Of Medicare Beneficiaries |
1090 |
Total Submitted Charge Amount |
2171005 |
Total Medicare Allowed Amount |
791358.88 |
Total Medicare Payment Amount |
587044.5 |
Total Medicare Standardized Payment Amount |
599050.6 |
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 |
33 |
Number Of Medical Services |
4983 |
Number Of Medicare Beneficiaries With Medical Services |
1090 |
Total Medical Submitted Charge Amount |
2171005 |
Total Medical Medicare Allowed Amount |
791358.88 |
Total Medical Medicare Payment Amount |
587044.5 |
Total Medical Medicare Standardized Payment Amount |
599050.6 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
554 |
Number Of Beneficiaries Age 75 to 84 |
350 |
Number Of Beneficiaries Age Greater 84 |
150 |
Number Of Female Beneficiaries |
665 |
Number Of Male Beneficiaries |
425 |
Number Of Non Hispanic White Beneficiaries |
918 |
Number Of Black or African American Beneficiaries |
42 |
Number Of AsianPacific Islander Beneficiaries |
19 |
Number Of Hispanic Beneficiaries |
88 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1016 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
74 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.055 |