National Provider Identifier [NPI]: |
1346395696 |
Last Name Of The Provider |
LE |
First Name Of The Provider |
MINH |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5704 S GESSNER DR |
Street Address 2 Of The Provider |
STE D |
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
77036 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
3573 |
Number Of Medicare Beneficiaries |
332 |
Total Submitted Charge Amount |
206653.17 |
Total Medicare Allowed Amount |
173225.88 |
Total Medicare Payment Amount |
121160.21 |
Total Medicare Standardized Payment Amount |
137246.54 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
125 |
Number Of Medicare Beneficiaries With Drug Services |
109 |
Total Drug Submitted ChargeAmount |
3250 |
Total Drug Medicare AllowedAmount |
1235.99 |
Total Drug Medicare PaymentAmount |
1202.59 |
Total Drug Medicare Standardized Payment Amount |
1202.59 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
3448 |
Number Of Medicare Beneficiaries With Medical Services |
332 |
Total Medical Submitted Charge Amount |
203403.17 |
Total Medical Medicare Allowed Amount |
171989.89 |
Total Medical Medicare Payment Amount |
119957.62 |
Total Medical Medicare Standardized Payment Amount |
136043.95 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
144 |
Number Of Beneficiaries Age 75 to 84 |
126 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
170 |
Number Of Male Beneficiaries |
162 |
Number Of Non Hispanic White Beneficiaries |
16 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
283 |
Number Of Hispanic Beneficiaries |
22 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
76 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
256 |
Percent Of With Atrial Fibrillation |
4 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
4 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
20 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1204 |