National Provider Identifier [NPI]: |
1962665364 |
Last Name Of The Provider |
LEA |
First Name Of The Provider |
BRIAN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2601 KENTUCKY AVE |
Street Address 2 Of The Provider |
SUITE 301 |
City Of The Provider |
PADUCAH |
Zip Code Of The Provider |
420033817 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
1827 |
Number Of Medicare Beneficiaries |
1024 |
Total Submitted Charge Amount |
156256 |
Total Medicare Allowed Amount |
68228.43 |
Total Medicare Payment Amount |
52924.42 |
Total Medicare Standardized Payment Amount |
56637.91 |
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 |
72 |
Number Of Beneficiaries Age Less65 |
205 |
Number Of Beneficiaries Age 65 to 74 |
374 |
Number Of Beneficiaries Age 75 to 84 |
295 |
Number Of Beneficiaries Age Greater 84 |
150 |
Number Of Female Beneficiaries |
527 |
Number Of Male Beneficiaries |
497 |
Number Of Non Hispanic White Beneficiaries |
952 |
Number Of Black or African American Beneficiaries |
61 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
759 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
265 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.5059 |