National Provider Identifier [NPI]: |
1659333870 |
Last Name Of The Provider |
BROWN |
First Name Of The Provider |
RYAN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1202 2ND AVE N |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT DODGE |
Zip Code Of The Provider |
505014115 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
2412 |
Number Of Medicare Beneficiaries |
1029 |
Total Submitted Charge Amount |
293326 |
Total Medicare Allowed Amount |
196081.94 |
Total Medicare Payment Amount |
126667.05 |
Total Medicare Standardized Payment Amount |
142380.8 |
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 |
29 |
Number Of Medical Services |
2412 |
Number Of Medicare Beneficiaries With Medical Services |
1029 |
Total Medical Submitted Charge Amount |
293326 |
Total Medical Medicare Allowed Amount |
196081.94 |
Total Medical Medicare Payment Amount |
126667.05 |
Total Medical Medicare Standardized Payment Amount |
142380.8 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
113 |
Number Of Beneficiaries Age 65 to 74 |
389 |
Number Of Beneficiaries Age 75 to 84 |
346 |
Number Of Beneficiaries Age Greater 84 |
181 |
Number Of Female Beneficiaries |
627 |
Number Of Male Beneficiaries |
402 |
Number Of Non Hispanic White Beneficiaries |
1009 |
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 |
885 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
144 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
34 |
Percent Of With Hypertension |
51 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9661 |