National Provider Identifier [NPI]: |
1952304933 |
Last Name Of The Provider |
LEE |
First Name Of The Provider |
YONG |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3672 MARATHON CIRCLE |
Street Address 2 Of The Provider |
STE 200 |
City Of The Provider |
AUSTELL |
Zip Code Of The Provider |
30106 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
70 |
Number Of Services |
4289 |
Number Of Medicare Beneficiaries |
638 |
Total Submitted Charge Amount |
977281 |
Total Medicare Allowed Amount |
263879.68 |
Total Medicare Payment Amount |
189435.86 |
Total Medicare Standardized Payment Amount |
187085.51 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
210 |
Number Of Medicare Beneficiaries With Drug Services |
91 |
Total Drug Submitted ChargeAmount |
4392 |
Total Drug Medicare AllowedAmount |
754.97 |
Total Drug Medicare PaymentAmount |
553.23 |
Total Drug Medicare Standardized Payment Amount |
553.23 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
66 |
Number Of Medical Services |
4079 |
Number Of Medicare Beneficiaries With Medical Services |
638 |
Total Medical Submitted Charge Amount |
972889 |
Total Medical Medicare Allowed Amount |
263124.71 |
Total Medical Medicare Payment Amount |
188882.63 |
Total Medical Medicare Standardized Payment Amount |
186532.28 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
201 |
Number Of Beneficiaries Age 65 to 74 |
230 |
Number Of Beneficiaries Age 75 to 84 |
172 |
Number Of Beneficiaries Age Greater 84 |
35 |
Number Of Female Beneficiaries |
423 |
Number Of Male Beneficiaries |
215 |
Number Of Non Hispanic White Beneficiaries |
521 |
Number Of Black or African American Beneficiaries |
105 |
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 |
507 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
131 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.4253 |