National Provider Identifier [NPI]: |
1316114465 |
Last Name Of The Provider |
LENZ |
First Name Of The Provider |
LYNETTE |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1155 MISSION ST SE |
Street Address 2 Of The Provider |
SUITE 205 |
City Of The Provider |
SALEM |
Zip Code Of The Provider |
97302 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
511 |
Number Of Medicare Beneficiaries |
271 |
Total Submitted Charge Amount |
105561.86 |
Total Medicare Allowed Amount |
38784.61 |
Total Medicare Payment Amount |
26848.09 |
Total Medicare Standardized Payment Amount |
33457.18 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
96 |
Number Of Beneficiaries Age 75 to 84 |
80 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
168 |
Number Of Male Beneficiaries |
103 |
Number Of Non Hispanic White Beneficiaries |
252 |
Number Of Black or African American Beneficiaries |
|
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 |
205 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
66 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
|
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2806 |