National Provider Identifier [NPI]: |
1639144660 |
Last Name Of The Provider |
LANE |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
39 BARKLEY CIR |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT MYERS |
Zip Code Of The Provider |
339077531 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Otolaryngology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
98 |
Number Of Services |
4287 |
Number Of Medicare Beneficiaries |
919 |
Total Submitted Charge Amount |
884006.2 |
Total Medicare Allowed Amount |
270463.94 |
Total Medicare Payment Amount |
200609.27 |
Total Medicare Standardized Payment Amount |
190249.91 |
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 |
98 |
Number Of Medical Services |
4287 |
Number Of Medicare Beneficiaries With Medical Services |
919 |
Total Medical Submitted Charge Amount |
884006.2 |
Total Medical Medicare Allowed Amount |
270463.94 |
Total Medical Medicare Payment Amount |
200609.27 |
Total Medical Medicare Standardized Payment Amount |
190249.91 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
93 |
Number Of Beneficiaries Age 65 to 74 |
379 |
Number Of Beneficiaries Age 75 to 84 |
325 |
Number Of Beneficiaries Age Greater 84 |
122 |
Number Of Female Beneficiaries |
456 |
Number Of Male Beneficiaries |
463 |
Number Of Non Hispanic White Beneficiaries |
810 |
Number Of Black or African American Beneficiaries |
31 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
53 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
787 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
132 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2664 |