National Provider Identifier [NPI]: |
1518953074 |
Last Name Of The Provider |
LEE |
First Name Of The Provider |
JOSEPH |
Middle Initial Of The Provider |
I |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6410 ROCKLEDGE DR |
Street Address 2 Of The Provider |
STE 201 |
City Of The Provider |
BETHESDA |
Zip Code Of The Provider |
208171809 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
54 |
Number Of Services |
7614 |
Number Of Medicare Beneficiaries |
1188 |
Total Submitted Charge Amount |
687089 |
Total Medicare Allowed Amount |
442498.88 |
Total Medicare Payment Amount |
326417.1 |
Total Medicare Standardized Payment Amount |
283298.3 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
41 |
Number Of Beneficiaries Age 65 to 74 |
624 |
Number Of Beneficiaries Age 75 to 84 |
368 |
Number Of Beneficiaries Age Greater 84 |
155 |
Number Of Female Beneficiaries |
635 |
Number Of Male Beneficiaries |
553 |
Number Of Non Hispanic White Beneficiaries |
996 |
Number Of Black or African American Beneficiaries |
21 |
Number Of AsianPacific Islander Beneficiaries |
83 |
Number Of Hispanic Beneficiaries |
51 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
37 |
Number Of Beneficiaries With Medicare Only Entitlement |
1052 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
136 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.8689 |