National Provider Identifier [NPI]: |
1063523330 |
Last Name Of The Provider |
RALPH |
First Name Of The Provider |
LEE |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6699 ALVARADO RD |
Street Address 2 Of The Provider |
SUITE 2100 |
City Of The Provider |
SAN DIEGO |
Zip Code Of The Provider |
921205238 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
77 |
Number Of Services |
693 |
Number Of Medicare Beneficiaries |
131 |
Total Submitted Charge Amount |
57667.16 |
Total Medicare Allowed Amount |
48449.99 |
Total Medicare Payment Amount |
34421.38 |
Total Medicare Standardized Payment Amount |
33501.26 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
113 |
Number Of Medicare Beneficiaries With Drug Services |
41 |
Total Drug Submitted ChargeAmount |
3352.16 |
Total Drug Medicare AllowedAmount |
2292.39 |
Total Drug Medicare PaymentAmount |
2055.64 |
Total Drug Medicare Standardized Payment Amount |
2055.64 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
69 |
Number Of Medical Services |
580 |
Number Of Medicare Beneficiaries With Medical Services |
131 |
Total Medical Submitted Charge Amount |
54315 |
Total Medical Medicare Allowed Amount |
46157.6 |
Total Medical Medicare Payment Amount |
32365.74 |
Total Medical Medicare Standardized Payment Amount |
31445.62 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
78 |
Number Of Beneficiaries Age 75 to 84 |
32 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
65 |
Number Of Male Beneficiaries |
66 |
Number Of Non Hispanic White Beneficiaries |
117 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
11 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
45 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7367 |