National Provider Identifier [NPI]: |
1447351622 |
Last Name Of The Provider |
LEE |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
Y |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1530 N 115TH ST |
Street Address 2 Of The Provider |
STE 104 |
City Of The Provider |
SEATTLE |
Zip Code Of The Provider |
981338421 |
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 |
42 |
Number Of Services |
1963 |
Number Of Medicare Beneficiaries |
292 |
Total Submitted Charge Amount |
319053 |
Total Medicare Allowed Amount |
192410.12 |
Total Medicare Payment Amount |
145684.13 |
Total Medicare Standardized Payment Amount |
136430.65 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
263 |
Number Of Medicare Beneficiaries With Drug Services |
89 |
Total Drug Submitted ChargeAmount |
3927 |
Total Drug Medicare AllowedAmount |
2114.59 |
Total Drug Medicare PaymentAmount |
1999.3 |
Total Drug Medicare Standardized Payment Amount |
1999.3 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
1700 |
Number Of Medicare Beneficiaries With Medical Services |
292 |
Total Medical Submitted Charge Amount |
315126 |
Total Medical Medicare Allowed Amount |
190295.53 |
Total Medical Medicare Payment Amount |
143684.83 |
Total Medical Medicare Standardized Payment Amount |
134431.35 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
103 |
Number Of Beneficiaries Age 75 to 84 |
96 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
142 |
Number Of Male Beneficiaries |
150 |
Number Of Non Hispanic White Beneficiaries |
255 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
17 |
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 |
20 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1858 |