National Provider Identifier [NPI]: |
1538125414 |
Last Name Of The Provider |
KOCH |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
566 TOLL GATE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
WARWICK |
Zip Code Of The Provider |
028862716 |
State Code Of The Provider |
RI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
2748 |
Number Of Medicare Beneficiaries |
634 |
Total Submitted Charge Amount |
2085882.56 |
Total Medicare Allowed Amount |
576294.4 |
Total Medicare Payment Amount |
442230.41 |
Total Medicare Standardized Payment Amount |
429887.27 |
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 |
35 |
Number Of Medical Services |
2748 |
Number Of Medicare Beneficiaries With Medical Services |
634 |
Total Medical Submitted Charge Amount |
2085882.56 |
Total Medical Medicare Allowed Amount |
576294.4 |
Total Medical Medicare Payment Amount |
442230.41 |
Total Medical Medicare Standardized Payment Amount |
429887.27 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
296 |
Number Of Beneficiaries Age 75 to 84 |
231 |
Number Of Beneficiaries Age Greater 84 |
62 |
Number Of Female Beneficiaries |
401 |
Number Of Male Beneficiaries |
233 |
Number Of Non Hispanic White Beneficiaries |
564 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
38 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
16 |
Number Of Beneficiaries With Medicare Only Entitlement |
505 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
129 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1661 |