National Provider Identifier [NPI]: |
1912914417 |
Last Name Of The Provider |
PITTMAN |
First Name Of The Provider |
WESLEY |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
OD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
501 E MILAM ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MEXIA |
Zip Code Of The Provider |
766672331 |
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 |
6 |
Number Of Services |
416 |
Number Of Medicare Beneficiaries |
351 |
Total Submitted Charge Amount |
46229 |
Total Medicare Allowed Amount |
45717.21 |
Total Medicare Payment Amount |
29513.14 |
Total Medicare Standardized Payment Amount |
33117.18 |
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 |
6 |
Number Of Medical Services |
416 |
Number Of Medicare Beneficiaries With Medical Services |
351 |
Total Medical Submitted Charge Amount |
46229 |
Total Medical Medicare Allowed Amount |
45717.21 |
Total Medical Medicare Payment Amount |
29513.14 |
Total Medical Medicare Standardized Payment Amount |
33117.18 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
125 |
Number Of Beneficiaries Age 65 to 74 |
128 |
Number Of Beneficiaries Age 75 to 84 |
72 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
183 |
Number Of Male Beneficiaries |
168 |
Number Of Non Hispanic White Beneficiaries |
270 |
Number Of Black or African American Beneficiaries |
61 |
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 |
179 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
172 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
20 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1459 |