National Provider Identifier [NPI]: |
1720085236 |
Last Name Of The Provider |
PEETS |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8216 N MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
DAYTON |
Zip Code Of The Provider |
454151641 |
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 |
50 |
Number Of Services |
2261 |
Number Of Medicare Beneficiaries |
816 |
Total Submitted Charge Amount |
399791 |
Total Medicare Allowed Amount |
369877.39 |
Total Medicare Payment Amount |
273982.82 |
Total Medicare Standardized Payment Amount |
284152.52 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
311 |
Number Of Beneficiaries Age 75 to 84 |
314 |
Number Of Beneficiaries Age Greater 84 |
159 |
Number Of Female Beneficiaries |
492 |
Number Of Male Beneficiaries |
324 |
Number Of Non Hispanic White Beneficiaries |
700 |
Number Of Black or African American Beneficiaries |
102 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
778 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.128 |