National Provider Identifier [NPI]: |
1528170859 |
Last Name Of The Provider |
LABBE |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2121 HIGHWAY 16 S |
Street Address 2 Of The Provider |
|
City Of The Provider |
GRAHAM |
Zip Code Of The Provider |
764504615 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
139 |
Number Of Medicare Beneficiaries |
119 |
Total Submitted Charge Amount |
15814.44 |
Total Medicare Allowed Amount |
11919.32 |
Total Medicare Payment Amount |
8095.68 |
Total Medicare Standardized Payment Amount |
9371.32 |
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 |
8 |
Number Of Medical Services |
139 |
Number Of Medicare Beneficiaries With Medical Services |
119 |
Total Medical Submitted Charge Amount |
15814.44 |
Total Medical Medicare Allowed Amount |
11919.32 |
Total Medical Medicare Payment Amount |
8095.68 |
Total Medical Medicare Standardized Payment Amount |
9371.32 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
47 |
Number Of Beneficiaries Age 75 to 84 |
50 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
70 |
Number Of Male Beneficiaries |
49 |
Number Of Non Hispanic White Beneficiaries |
108 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
85 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
34 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2095 |