National Provider Identifier [NPI]: |
1093757981 |
Last Name Of The Provider |
LEE |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11315 BRIDGEPORT WAY SW |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAKEWOOD |
Zip Code Of The Provider |
984993004 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
49 |
Number Of Services |
1015 |
Number Of Medicare Beneficiaries |
576 |
Total Submitted Charge Amount |
501525 |
Total Medicare Allowed Amount |
102041.54 |
Total Medicare Payment Amount |
79069.09 |
Total Medicare Standardized Payment Amount |
80565.87 |
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 |
49 |
Number Of Medical Services |
1015 |
Number Of Medicare Beneficiaries With Medical Services |
576 |
Total Medical Submitted Charge Amount |
501525 |
Total Medical Medicare Allowed Amount |
102041.54 |
Total Medical Medicare Payment Amount |
79069.09 |
Total Medical Medicare Standardized Payment Amount |
80565.87 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
206 |
Number Of Beneficiaries Age 65 to 74 |
141 |
Number Of Beneficiaries Age 75 to 84 |
126 |
Number Of Beneficiaries Age Greater 84 |
103 |
Number Of Female Beneficiaries |
326 |
Number Of Male Beneficiaries |
250 |
Number Of Non Hispanic White Beneficiaries |
408 |
Number Of Black or African American Beneficiaries |
64 |
Number Of AsianPacific Islander Beneficiaries |
49 |
Number Of Hispanic Beneficiaries |
33 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
306 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
270 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.6416 |