National Provider Identifier [NPI]: |
1619932720 |
Last Name Of The Provider |
LEMPP |
First Name Of The Provider |
RYAN |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
OD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1601 AVE D |
Street Address 2 Of The Provider |
|
City Of The Provider |
COUNCIL BLUFFS |
Zip Code Of The Provider |
515012559 |
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 |
15 |
Number Of Services |
180 |
Number Of Medicare Beneficiaries |
125 |
Total Submitted Charge Amount |
22215 |
Total Medicare Allowed Amount |
17729.58 |
Total Medicare Payment Amount |
12215.18 |
Total Medicare Standardized Payment Amount |
13600.92 |
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 |
15 |
Number Of Medical Services |
180 |
Number Of Medicare Beneficiaries With Medical Services |
125 |
Total Medical Submitted Charge Amount |
22215 |
Total Medical Medicare Allowed Amount |
17729.58 |
Total Medical Medicare Payment Amount |
12215.18 |
Total Medical Medicare Standardized Payment Amount |
13600.92 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
16 |
Number Of Beneficiaries Age 65 to 74 |
67 |
Number Of Beneficiaries Age 75 to 84 |
28 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
63 |
Number Of Male Beneficiaries |
62 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
98 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
27 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0246 |