National Provider Identifier [NPI]: |
1073660627 |
Last Name Of The Provider |
LEWIS |
First Name Of The Provider |
FELICIA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
399 W CAMPBELL RD |
Street Address 2 Of The Provider |
MEDICAL PLAZA 2, SUITE 102 |
City Of The Provider |
RICHARDSON |
Zip Code Of The Provider |
750803595 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
1336 |
Number Of Medicare Beneficiaries |
176 |
Total Submitted Charge Amount |
186151 |
Total Medicare Allowed Amount |
91908.04 |
Total Medicare Payment Amount |
65181.07 |
Total Medicare Standardized Payment Amount |
68654.6 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
38 |
Number Of Medicare Beneficiaries With Drug Services |
22 |
Total Drug Submitted ChargeAmount |
845 |
Total Drug Medicare AllowedAmount |
372.84 |
Total Drug Medicare PaymentAmount |
334.67 |
Total Drug Medicare Standardized Payment Amount |
334.67 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
1298 |
Number Of Medicare Beneficiaries With Medical Services |
176 |
Total Medical Submitted Charge Amount |
185306 |
Total Medical Medicare Allowed Amount |
91535.2 |
Total Medical Medicare Payment Amount |
64846.4 |
Total Medical Medicare Standardized Payment Amount |
68319.93 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
73 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
143 |
Number Of Male Beneficiaries |
33 |
Number Of Non Hispanic White Beneficiaries |
112 |
Number Of Black or African American Beneficiaries |
42 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
129 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
47 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0746 |