National Provider Identifier [NPI]: |
1255354973 |
Last Name Of The Provider |
LEE |
First Name Of The Provider |
DOUGLAS |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
350 7TH ST N |
Street Address 2 Of The Provider |
|
City Of The Provider |
NAPLES |
Zip Code Of The Provider |
341025754 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
1893 |
Number Of Medicare Beneficiaries |
1090 |
Total Submitted Charge Amount |
858889 |
Total Medicare Allowed Amount |
210608.07 |
Total Medicare Payment Amount |
163363.03 |
Total Medicare Standardized Payment Amount |
155262.98 |
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 |
35 |
Number Of Medical Services |
1893 |
Number Of Medicare Beneficiaries With Medical Services |
1090 |
Total Medical Submitted Charge Amount |
858889 |
Total Medical Medicare Allowed Amount |
210608.07 |
Total Medical Medicare Payment Amount |
163363.03 |
Total Medical Medicare Standardized Payment Amount |
155262.98 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
154 |
Number Of Beneficiaries Age 65 to 74 |
322 |
Number Of Beneficiaries Age 75 to 84 |
347 |
Number Of Beneficiaries Age Greater 84 |
267 |
Number Of Female Beneficiaries |
566 |
Number Of Male Beneficiaries |
524 |
Number Of Non Hispanic White Beneficiaries |
966 |
Number Of Black or African American Beneficiaries |
59 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
51 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
871 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
219 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.7275 |