National Provider Identifier [NPI]: |
1255362984 |
Last Name Of The Provider |
LEE |
First Name Of The Provider |
PAMELA |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
P.A. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3610 ATLANTIC AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
LONG BEACH |
Zip Code Of The Provider |
908073418 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
662 |
Number Of Medicare Beneficiaries |
253 |
Total Submitted Charge Amount |
117767 |
Total Medicare Allowed Amount |
51173.66 |
Total Medicare Payment Amount |
40116.16 |
Total Medicare Standardized Payment Amount |
44212.04 |
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 |
9 |
Number Of Medical Services |
662 |
Number Of Medicare Beneficiaries With Medical Services |
253 |
Total Medical Submitted Charge Amount |
117767 |
Total Medical Medicare Allowed Amount |
51173.66 |
Total Medical Medicare Payment Amount |
40116.16 |
Total Medical Medicare Standardized Payment Amount |
44212.04 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
71 |
Number Of Beneficiaries Age 65 to 74 |
77 |
Number Of Beneficiaries Age 75 to 84 |
70 |
Number Of Beneficiaries Age Greater 84 |
35 |
Number Of Female Beneficiaries |
144 |
Number Of Male Beneficiaries |
109 |
Number Of Non Hispanic White Beneficiaries |
92 |
Number Of Black or African American Beneficiaries |
65 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
54 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
76 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
177 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
58 |
Percent Of With Chronic Kidney Disease |
58 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
62 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
26 |
Average HCC Risk Score Of Beneficiaries |
2.62 |