National Provider Identifier [NPI]: |
1104853753 |
Last Name Of The Provider |
TAM |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1000 REGENCY CT |
Street Address 2 Of The Provider |
STE. 100 |
City Of The Provider |
TOLEDO |
Zip Code Of The Provider |
436233074 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
44 |
Number Of Services |
2349 |
Number Of Medicare Beneficiaries |
880 |
Total Submitted Charge Amount |
573975 |
Total Medicare Allowed Amount |
295735.59 |
Total Medicare Payment Amount |
211774.12 |
Total Medicare Standardized Payment Amount |
223678.8 |
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 |
44 |
Number Of Medical Services |
2349 |
Number Of Medicare Beneficiaries With Medical Services |
880 |
Total Medical Submitted Charge Amount |
573975 |
Total Medical Medicare Allowed Amount |
295735.59 |
Total Medical Medicare Payment Amount |
211774.12 |
Total Medical Medicare Standardized Payment Amount |
223678.8 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
85 |
Number Of Beneficiaries Age 65 to 74 |
345 |
Number Of Beneficiaries Age 75 to 84 |
292 |
Number Of Beneficiaries Age Greater 84 |
158 |
Number Of Female Beneficiaries |
521 |
Number Of Male Beneficiaries |
359 |
Number Of Non Hispanic White Beneficiaries |
782 |
Number Of Black or African American Beneficiaries |
48 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
26 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
762 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
118 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1977 |