National Provider Identifier [NPI]: |
1477834265 |
Last Name Of The Provider |
KEYES |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
OD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
56 FRANKLIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
RUMFORD |
Zip Code Of The Provider |
042762060 |
State Code Of The Provider |
ME |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
4096 |
Number Of Medicare Beneficiaries |
481 |
Total Submitted Charge Amount |
102637 |
Total Medicare Allowed Amount |
80207.61 |
Total Medicare Payment Amount |
51888.72 |
Total Medicare Standardized Payment Amount |
56214.29 |
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 |
25 |
Number Of Medical Services |
4096 |
Number Of Medicare Beneficiaries With Medical Services |
481 |
Total Medical Submitted Charge Amount |
102637 |
Total Medical Medicare Allowed Amount |
80207.61 |
Total Medical Medicare Payment Amount |
51888.72 |
Total Medical Medicare Standardized Payment Amount |
56214.29 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
133 |
Number Of Beneficiaries Age 65 to 74 |
167 |
Number Of Beneficiaries Age 75 to 84 |
111 |
Number Of Beneficiaries Age Greater 84 |
70 |
Number Of Female Beneficiaries |
281 |
Number Of Male Beneficiaries |
200 |
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 |
251 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
230 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
25 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9893 |