National Provider Identifier [NPI]: |
1063447811 |
Last Name Of The Provider |
LEWIS |
First Name Of The Provider |
GREG |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9850 GENESEE AVE |
Street Address 2 Of The Provider |
SUITE 900 |
City Of The Provider |
LA JOLLA |
Zip Code Of The Provider |
920371224 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
1187 |
Number Of Medicare Beneficiaries |
555 |
Total Submitted Charge Amount |
207839 |
Total Medicare Allowed Amount |
124884.78 |
Total Medicare Payment Amount |
96523.14 |
Total Medicare Standardized Payment Amount |
94580.44 |
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 |
24 |
Number Of Medical Services |
1187 |
Number Of Medicare Beneficiaries With Medical Services |
555 |
Total Medical Submitted Charge Amount |
207839 |
Total Medical Medicare Allowed Amount |
124884.78 |
Total Medical Medicare Payment Amount |
96523.14 |
Total Medical Medicare Standardized Payment Amount |
94580.44 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
75 |
Number Of Beneficiaries Age 65 to 74 |
128 |
Number Of Beneficiaries Age 75 to 84 |
186 |
Number Of Beneficiaries Age Greater 84 |
166 |
Number Of Female Beneficiaries |
308 |
Number Of Male Beneficiaries |
247 |
Number Of Non Hispanic White Beneficiaries |
414 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
47 |
Number Of Hispanic Beneficiaries |
52 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
334 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
221 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
39 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.4936 |