National Provider Identifier [NPI]: |
1841476249 |
Last Name Of The Provider |
LEE |
First Name Of The Provider |
EUNYOUNG |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
ANP, PHD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1710 WHITFIELD DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
BEDFORD |
Zip Code Of The Provider |
245231401 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
5 |
Number Of Services |
680 |
Number Of Medicare Beneficiaries |
235 |
Total Submitted Charge Amount |
90554 |
Total Medicare Allowed Amount |
63288.41 |
Total Medicare Payment Amount |
44198.86 |
Total Medicare Standardized Payment Amount |
53971.1 |
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 |
5 |
Number Of Medical Services |
680 |
Number Of Medicare Beneficiaries With Medical Services |
235 |
Total Medical Submitted Charge Amount |
90554 |
Total Medical Medicare Allowed Amount |
63288.41 |
Total Medical Medicare Payment Amount |
44198.86 |
Total Medical Medicare Standardized Payment Amount |
53971.1 |
Average Age Of Beneficiaries |
81 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
40 |
Number Of Beneficiaries Age 75 to 84 |
85 |
Number Of Beneficiaries Age Greater 84 |
92 |
Number Of Female Beneficiaries |
156 |
Number Of Male Beneficiaries |
79 |
Number Of Non Hispanic White Beneficiaries |
215 |
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 |
108 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
127 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
53 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
29 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.8161 |