National Provider Identifier [NPI]: |
1043312499 |
Last Name Of The Provider |
MERRILL |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
OD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
406 E THREE NOTCH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ANDALUSIA |
Zip Code Of The Provider |
364203166 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
4 |
Number Of Services |
434 |
Number Of Medicare Beneficiaries |
308 |
Total Submitted Charge Amount |
41165 |
Total Medicare Allowed Amount |
35236.29 |
Total Medicare Payment Amount |
22888.69 |
Total Medicare Standardized Payment Amount |
33161.88 |
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 |
4 |
Number Of Medical Services |
434 |
Number Of Medicare Beneficiaries With Medical Services |
308 |
Total Medical Submitted Charge Amount |
41165 |
Total Medical Medicare Allowed Amount |
35236.29 |
Total Medical Medicare Payment Amount |
22888.69 |
Total Medical Medicare Standardized Payment Amount |
33161.88 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
118 |
Number Of Beneficiaries Age 75 to 84 |
113 |
Number Of Beneficiaries Age Greater 84 |
62 |
Number Of Female Beneficiaries |
199 |
Number Of Male Beneficiaries |
109 |
Number Of Non Hispanic White Beneficiaries |
291 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
257 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
51 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
10 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
0.9891 |