National Provider Identifier [NPI]: |
1700814795 |
Last Name Of The Provider |
LEE |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
42 E LAUREL RD |
Street Address 2 Of The Provider |
UDP #1800 |
City Of The Provider |
STRATFORD |
Zip Code Of The Provider |
080841354 |
State Code Of The Provider |
NJ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
1753 |
Number Of Medicare Beneficiaries |
514 |
Total Submitted Charge Amount |
266580 |
Total Medicare Allowed Amount |
174898.72 |
Total Medicare Payment Amount |
135189.38 |
Total Medicare Standardized Payment Amount |
115483.13 |
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 |
24 |
Number Of Medical Services |
1753 |
Number Of Medicare Beneficiaries With Medical Services |
514 |
Total Medical Submitted Charge Amount |
266580 |
Total Medical Medicare Allowed Amount |
174898.72 |
Total Medical Medicare Payment Amount |
135189.38 |
Total Medical Medicare Standardized Payment Amount |
115483.13 |
Average Age Of Beneficiaries |
82 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
83 |
Number Of Beneficiaries Age 75 to 84 |
163 |
Number Of Beneficiaries Age Greater 84 |
246 |
Number Of Female Beneficiaries |
322 |
Number Of Male Beneficiaries |
192 |
Number Of Non Hispanic White Beneficiaries |
392 |
Number Of Black or African American Beneficiaries |
70 |
Number Of AsianPacific Islander Beneficiaries |
36 |
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 |
352 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
162 |
Percent Of With Atrial Fibrillation |
31 |
Percent Of With Alzheimers Disease or Dementia |
57 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
59 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
68 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.3016 |