National Provider Identifier [NPI]: |
1235115429 |
Last Name Of The Provider |
LEE |
First Name Of The Provider |
MYUNG |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
L6 OMEGA DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEWARK |
Zip Code Of The Provider |
197132077 |
State Code Of The Provider |
DE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
140 |
Number Of Services |
4033 |
Number Of Medicare Beneficiaries |
664 |
Total Submitted Charge Amount |
633752.51 |
Total Medicare Allowed Amount |
170425.62 |
Total Medicare Payment Amount |
126755.43 |
Total Medicare Standardized Payment Amount |
125762.86 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
2949 |
Number Of Medicare Beneficiaries With Drug Services |
87 |
Total Drug Submitted ChargeAmount |
8313 |
Total Drug Medicare AllowedAmount |
2942.63 |
Total Drug Medicare PaymentAmount |
2290.78 |
Total Drug Medicare Standardized Payment Amount |
2290.78 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
135 |
Number Of Medical Services |
1084 |
Number Of Medicare Beneficiaries With Medical Services |
664 |
Total Medical Submitted Charge Amount |
625439.51 |
Total Medical Medicare Allowed Amount |
167482.99 |
Total Medical Medicare Payment Amount |
124464.65 |
Total Medical Medicare Standardized Payment Amount |
123472.08 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
123 |
Number Of Beneficiaries Age 65 to 74 |
311 |
Number Of Beneficiaries Age 75 to 84 |
173 |
Number Of Beneficiaries Age Greater 84 |
57 |
Number Of Female Beneficiaries |
415 |
Number Of Male Beneficiaries |
249 |
Number Of Non Hispanic White Beneficiaries |
523 |
Number Of Black or African American Beneficiaries |
94 |
Number Of AsianPacific Islander Beneficiaries |
20 |
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
568 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
96 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1492 |