National Provider Identifier [NPI]: |
1699893545 |
Last Name Of The Provider |
SLOCUMB |
First Name Of The Provider |
RONALD |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
79 WAWECUS ST |
Street Address 2 Of The Provider |
SUITE 105 |
City Of The Provider |
NORWICH |
Zip Code Of The Provider |
063602160 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
1938 |
Number Of Medicare Beneficiaries |
620 |
Total Submitted Charge Amount |
538210 |
Total Medicare Allowed Amount |
223003.75 |
Total Medicare Payment Amount |
161419.21 |
Total Medicare Standardized Payment Amount |
149998.12 |
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 |
30 |
Number Of Medical Services |
1938 |
Number Of Medicare Beneficiaries With Medical Services |
620 |
Total Medical Submitted Charge Amount |
538210 |
Total Medical Medicare Allowed Amount |
223003.75 |
Total Medical Medicare Payment Amount |
161419.21 |
Total Medical Medicare Standardized Payment Amount |
149998.12 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
172 |
Number Of Beneficiaries Age 65 to 74 |
262 |
Number Of Beneficiaries Age 75 to 84 |
144 |
Number Of Beneficiaries Age Greater 84 |
42 |
Number Of Female Beneficiaries |
347 |
Number Of Male Beneficiaries |
273 |
Number Of Non Hispanic White Beneficiaries |
460 |
Number Of Black or African American Beneficiaries |
64 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
66 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
17 |
Number Of Beneficiaries With Medicare Only Entitlement |
323 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
297 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2723 |