National Provider Identifier [NPI]: |
1043426711 |
Last Name Of The Provider |
WANG |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3105 COBB PKWY NW |
Street Address 2 Of The Provider |
|
City Of The Provider |
KENNESAW |
Zip Code Of The Provider |
301521013 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
331 |
Number Of Medicare Beneficiaries |
167 |
Total Submitted Charge Amount |
36183 |
Total Medicare Allowed Amount |
34445.25 |
Total Medicare Payment Amount |
22735.49 |
Total Medicare Standardized Payment Amount |
24206.2 |
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 |
11 |
Number Of Medical Services |
331 |
Number Of Medicare Beneficiaries With Medical Services |
167 |
Total Medical Submitted Charge Amount |
36183 |
Total Medical Medicare Allowed Amount |
34445.25 |
Total Medical Medicare Payment Amount |
22735.49 |
Total Medical Medicare Standardized Payment Amount |
24206.2 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
97 |
Number Of Beneficiaries Age 75 to 84 |
38 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
107 |
Number Of Male Beneficiaries |
60 |
Number Of Non Hispanic White Beneficiaries |
147 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
143 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
|
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1071 |