National Provider Identifier [NPI]: |
1124082706 |
Last Name Of The Provider |
LENZ |
First Name Of The Provider |
JEFFREY |
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 |
1235 8TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
WEST DES MOINES |
Zip Code Of The Provider |
502652623 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
1528 |
Number Of Medicare Beneficiaries |
211 |
Total Submitted Charge Amount |
100629 |
Total Medicare Allowed Amount |
55258.34 |
Total Medicare Payment Amount |
35972.62 |
Total Medicare Standardized Payment Amount |
40710.46 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
57 |
Number Of Medicare Beneficiaries With Drug Services |
24 |
Total Drug Submitted ChargeAmount |
501 |
Total Drug Medicare AllowedAmount |
187.77 |
Total Drug Medicare PaymentAmount |
111.7 |
Total Drug Medicare Standardized Payment Amount |
111.7 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
44 |
Number Of Medical Services |
1471 |
Number Of Medicare Beneficiaries With Medical Services |
211 |
Total Medical Submitted Charge Amount |
100128 |
Total Medical Medicare Allowed Amount |
55070.57 |
Total Medical Medicare Payment Amount |
35860.92 |
Total Medical Medicare Standardized Payment Amount |
40598.76 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
144 |
Number Of Beneficiaries Age 75 to 84 |
46 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
112 |
Number Of Male Beneficiaries |
99 |
Number Of Non Hispanic White Beneficiaries |
196 |
Number Of Black or African American Beneficiaries |
0 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7162 |