National Provider Identifier [NPI]: |
1871583096 |
Last Name Of The Provider |
LEE |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD PHD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
55 FRUIT ST |
Street Address 2 Of The Provider |
YAW 7E |
City Of The Provider |
BOSTON |
Zip Code Of The Provider |
021142621 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
902 |
Number Of Medicare Beneficiaries |
380 |
Total Submitted Charge Amount |
266717 |
Total Medicare Allowed Amount |
78972.8 |
Total Medicare Payment Amount |
58795.53 |
Total Medicare Standardized Payment Amount |
56557.61 |
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 |
12 |
Number Of Medical Services |
902 |
Number Of Medicare Beneficiaries With Medical Services |
380 |
Total Medical Submitted Charge Amount |
266717 |
Total Medical Medicare Allowed Amount |
78972.8 |
Total Medical Medicare Payment Amount |
58795.53 |
Total Medical Medicare Standardized Payment Amount |
56557.61 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
173 |
Number Of Beneficiaries Age 75 to 84 |
145 |
Number Of Beneficiaries Age Greater 84 |
42 |
Number Of Female Beneficiaries |
37 |
Number Of Male Beneficiaries |
343 |
Number Of Non Hispanic White Beneficiaries |
344 |
Number Of Black or African American Beneficiaries |
12 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
336 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
44 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
71 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.8491 |