National Provider Identifier [NPI]: |
1548233430 |
Last Name Of The Provider |
MORISY |
First Name Of The Provider |
LEE |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6025 WALNUT GROVE RD |
Street Address 2 Of The Provider |
STE 201 |
City Of The Provider |
MEMPHIS |
Zip Code Of The Provider |
381202131 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
67 |
Number Of Services |
493 |
Number Of Medicare Beneficiaries |
207 |
Total Submitted Charge Amount |
301635 |
Total Medicare Allowed Amount |
114227.38 |
Total Medicare Payment Amount |
86339.92 |
Total Medicare Standardized Payment Amount |
95132.75 |
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 |
67 |
Number Of Medical Services |
493 |
Number Of Medicare Beneficiaries With Medical Services |
207 |
Total Medical Submitted Charge Amount |
301635 |
Total Medical Medicare Allowed Amount |
114227.38 |
Total Medical Medicare Payment Amount |
86339.92 |
Total Medical Medicare Standardized Payment Amount |
95132.75 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
43 |
Number Of Beneficiaries Age 65 to 74 |
92 |
Number Of Beneficiaries Age 75 to 84 |
60 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
124 |
Number Of Male Beneficiaries |
83 |
Number Of Non Hispanic White Beneficiaries |
118 |
Number Of Black or African American Beneficiaries |
|
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 |
164 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
43 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
26 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.8355 |