National Provider Identifier [NPI]: |
1730376583 |
Last Name Of The Provider |
LEE |
First Name Of The Provider |
BRIAN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2925 LORD BALTIMORE DR |
Street Address 2 Of The Provider |
SUITE 300 |
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
212442653 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
43 |
Number Of Services |
1208 |
Number Of Medicare Beneficiaries |
289 |
Total Submitted Charge Amount |
287650 |
Total Medicare Allowed Amount |
132767.02 |
Total Medicare Payment Amount |
101115.84 |
Total Medicare Standardized Payment Amount |
79370.34 |
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 |
74 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
138 |
Number Of Beneficiaries Age 75 to 84 |
89 |
Number Of Beneficiaries Age Greater 84 |
42 |
Number Of Female Beneficiaries |
183 |
Number Of Male Beneficiaries |
106 |
Number Of Non Hispanic White Beneficiaries |
181 |
Number Of Black or African American Beneficiaries |
76 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
254 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
35 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1477 |