National Provider Identifier [NPI]: |
1194820290 |
Last Name Of The Provider |
LEE |
First Name Of The Provider |
KATIE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1321 COLBY AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
EVERETT |
Zip Code Of The Provider |
982011665 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
759 |
Number Of Medicare Beneficiaries |
265 |
Total Submitted Charge Amount |
162404 |
Total Medicare Allowed Amount |
71979.16 |
Total Medicare Payment Amount |
54430.9 |
Total Medicare Standardized Payment Amount |
55505.07 |
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 |
15 |
Number Of Medical Services |
759 |
Number Of Medicare Beneficiaries With Medical Services |
265 |
Total Medical Submitted Charge Amount |
162404 |
Total Medical Medicare Allowed Amount |
71979.16 |
Total Medical Medicare Payment Amount |
54430.9 |
Total Medical Medicare Standardized Payment Amount |
55505.07 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
60 |
Number Of Beneficiaries Age 65 to 74 |
78 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
59 |
Number Of Female Beneficiaries |
155 |
Number Of Male Beneficiaries |
110 |
Number Of Non Hispanic White Beneficiaries |
232 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
14 |
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 |
156 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
109 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.7473 |