National Provider Identifier [NPI]: |
1104882760 |
Last Name Of The Provider |
STAHL |
First Name Of The Provider |
STEPHEN |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5806 W CAMELBACK RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
GLENDALE |
Zip Code Of The Provider |
853017405 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
1087 |
Number Of Medicare Beneficiaries |
519 |
Total Submitted Charge Amount |
136729.07 |
Total Medicare Allowed Amount |
97034.78 |
Total Medicare Payment Amount |
63066.66 |
Total Medicare Standardized Payment Amount |
63798.47 |
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 |
75 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
261 |
Number Of Beneficiaries Age 75 to 84 |
167 |
Number Of Beneficiaries Age Greater 84 |
69 |
Number Of Female Beneficiaries |
300 |
Number Of Male Beneficiaries |
219 |
Number Of Non Hispanic White Beneficiaries |
485 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
23 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
475 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
44 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.8968 |