National Provider Identifier [NPI]: |
1831250943 |
Last Name Of The Provider |
LEE |
First Name Of The Provider |
PATRICK |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
100 MCGREGOR ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MANCHESTER |
Zip Code Of The Provider |
031023730 |
State Code Of The Provider |
NH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
896 |
Number Of Medicare Beneficiaries |
711 |
Total Submitted Charge Amount |
404621 |
Total Medicare Allowed Amount |
128268.7 |
Total Medicare Payment Amount |
97859.37 |
Total Medicare Standardized Payment Amount |
97678.07 |
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 |
29 |
Number Of Medical Services |
896 |
Number Of Medicare Beneficiaries With Medical Services |
711 |
Total Medical Submitted Charge Amount |
404621 |
Total Medical Medicare Allowed Amount |
128268.7 |
Total Medical Medicare Payment Amount |
97859.37 |
Total Medical Medicare Standardized Payment Amount |
97678.07 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
292 |
Number Of Beneficiaries Age 65 to 74 |
148 |
Number Of Beneficiaries Age 75 to 84 |
146 |
Number Of Beneficiaries Age Greater 84 |
125 |
Number Of Female Beneficiaries |
388 |
Number Of Male Beneficiaries |
323 |
Number Of Non Hispanic White Beneficiaries |
662 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
14 |
Number Of Beneficiaries With Medicare Only Entitlement |
422 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
289 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
22 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
50 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.6969 |