National Provider Identifier [NPI]: |
1902893928 |
Last Name Of The Provider |
LEWIS |
First Name Of The Provider |
CARLTON |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10 MEDICAL CENTER BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LUFKIN |
Zip Code Of The Provider |
759043163 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
66 |
Number Of Services |
4047 |
Number Of Medicare Beneficiaries |
458 |
Total Submitted Charge Amount |
426961 |
Total Medicare Allowed Amount |
200976.47 |
Total Medicare Payment Amount |
145689.5 |
Total Medicare Standardized Payment Amount |
153806.74 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
815 |
Number Of Medicare Beneficiaries With Drug Services |
223 |
Total Drug Submitted ChargeAmount |
18030 |
Total Drug Medicare AllowedAmount |
3159.81 |
Total Drug Medicare PaymentAmount |
2869.88 |
Total Drug Medicare Standardized Payment Amount |
2869.88 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
53 |
Number Of Medical Services |
3232 |
Number Of Medicare Beneficiaries With Medical Services |
458 |
Total Medical Submitted Charge Amount |
408931 |
Total Medical Medicare Allowed Amount |
197816.66 |
Total Medical Medicare Payment Amount |
142819.62 |
Total Medical Medicare Standardized Payment Amount |
150936.86 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
55 |
Number Of Beneficiaries Age 65 to 74 |
183 |
Number Of Beneficiaries Age 75 to 84 |
142 |
Number Of Beneficiaries Age Greater 84 |
78 |
Number Of Female Beneficiaries |
256 |
Number Of Male Beneficiaries |
202 |
Number Of Non Hispanic White Beneficiaries |
408 |
Number Of Black or African American Beneficiaries |
39 |
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 |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
357 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
101 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.5465 |