National Provider Identifier [NPI]: |
1043272883 |
Last Name Of The Provider |
LESTER |
First Name Of The Provider |
RANDOLPH |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1441 N BECKLEY |
Street Address 2 Of The Provider |
|
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752031201 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
2103 |
Number Of Medicare Beneficiaries |
616 |
Total Submitted Charge Amount |
357778 |
Total Medicare Allowed Amount |
71839.74 |
Total Medicare Payment Amount |
56022.52 |
Total Medicare Standardized Payment Amount |
46705.81 |
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 |
2103 |
Number Of Medicare Beneficiaries With Medical Services |
616 |
Total Medical Submitted Charge Amount |
357778 |
Total Medical Medicare Allowed Amount |
71839.74 |
Total Medical Medicare Payment Amount |
56022.52 |
Total Medical Medicare Standardized Payment Amount |
46705.81 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
174 |
Number Of Beneficiaries Age 65 to 74 |
240 |
Number Of Beneficiaries Age 75 to 84 |
157 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
375 |
Number Of Male Beneficiaries |
241 |
Number Of Non Hispanic White Beneficiaries |
337 |
Number Of Black or African American Beneficiaries |
190 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
77 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
428 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
188 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.319 |