| National Provider Identifier [NPI]: | 1497747968 |
| Last Name Of The Provider | LEWIS |
| First Name Of The Provider | JEREMIAH |
| 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 | 40 CROSS ST |
| Street Address 2 Of The Provider | 4TH FL |
| City Of The Provider | NORWALK |
| Zip Code Of The Provider | 068514647 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 64 |
| Number Of Services | 2392 |
| Number Of Medicare Beneficiaries | 271 |
| Total Submitted Charge Amount | 218010 |
| Total Medicare Allowed Amount | 155970.3 |
| Total Medicare Payment Amount | 115117.61 |
| Total Medicare Standardized Payment Amount | 108488.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 404 |
| Number Of Medicare Beneficiaries With Drug Services | 118 |
| Total Drug Submitted ChargeAmount | 9647 |
| Total Drug Medicare AllowedAmount | 3881.86 |
| Total Drug Medicare PaymentAmount | 3348.73 |
| Total Drug Medicare Standardized Payment Amount | 3348.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 1988 |
| Number Of Medicare Beneficiaries With Medical Services | 271 |
| Total Medical Submitted Charge Amount | 208363 |
| Total Medical Medicare Allowed Amount | 152088.44 |
| Total Medical Medicare Payment Amount | 111768.88 |
| Total Medical Medicare Standardized Payment Amount | 105139.34 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 97 |
| Number Of Beneficiaries Age 75 to 84 | 93 |
| Number Of Beneficiaries Age Greater 84 | 59 |
| Number Of Female Beneficiaries | 142 |
| Number Of Male Beneficiaries | 129 |
| Number Of Non Hispanic White Beneficiaries | 223 |
| Number Of Black or African American Beneficiaries | 28 |
| 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 | 226 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 45 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0099 |