National Provider Identifier [NPI]: |
1376522912 |
Last Name Of The Provider |
LEE |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
540 UNION BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
WEST ISLIP |
Zip Code Of The Provider |
117953105 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
70 |
Number Of Services |
2700 |
Number Of Medicare Beneficiaries |
1021 |
Total Submitted Charge Amount |
1251300 |
Total Medicare Allowed Amount |
357075.98 |
Total Medicare Payment Amount |
273647.01 |
Total Medicare Standardized Payment Amount |
237154.94 |
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 |
70 |
Number Of Medical Services |
2700 |
Number Of Medicare Beneficiaries With Medical Services |
1021 |
Total Medical Submitted Charge Amount |
1251300 |
Total Medical Medicare Allowed Amount |
357075.98 |
Total Medical Medicare Payment Amount |
273647.01 |
Total Medical Medicare Standardized Payment Amount |
237154.94 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
100 |
Number Of Beneficiaries Age 65 to 74 |
350 |
Number Of Beneficiaries Age 75 to 84 |
394 |
Number Of Beneficiaries Age Greater 84 |
177 |
Number Of Female Beneficiaries |
513 |
Number Of Male Beneficiaries |
508 |
Number Of Non Hispanic White Beneficiaries |
874 |
Number Of Black or African American Beneficiaries |
59 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
65 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
853 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
168 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.6907 |