National Provider Identifier [NPI]: |
1407857055 |
Last Name Of The Provider |
LEE |
First Name Of The Provider |
HENRY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2 LONGVIEW AVENUE |
Street Address 2 Of The Provider |
LOWER LEVEL |
City Of The Provider |
WHITE PLAINS |
Zip Code Of The Provider |
10601 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Radiation Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
1026 |
Number Of Medicare Beneficiaries |
180 |
Total Submitted Charge Amount |
722144 |
Total Medicare Allowed Amount |
154323.46 |
Total Medicare Payment Amount |
119879.86 |
Total Medicare Standardized Payment Amount |
107811.78 |
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 |
24 |
Number Of Medical Services |
1026 |
Number Of Medicare Beneficiaries With Medical Services |
180 |
Total Medical Submitted Charge Amount |
722144 |
Total Medical Medicare Allowed Amount |
154323.46 |
Total Medical Medicare Payment Amount |
119879.86 |
Total Medical Medicare Standardized Payment Amount |
107811.78 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
67 |
Number Of Beneficiaries Age 75 to 84 |
72 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
70 |
Number Of Male Beneficiaries |
110 |
Number Of Non Hispanic White Beneficiaries |
142 |
Number Of Black or African American Beneficiaries |
22 |
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 |
159 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
66 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.7738 |