National Provider Identifier [NPI]: |
1962421016 |
Last Name Of The Provider |
LE |
First Name Of The Provider |
RICHARD |
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 |
11918 VETERANS MEMORIAL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770671834 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
3396 |
Number Of Medicare Beneficiaries |
332 |
Total Submitted Charge Amount |
199389.2 |
Total Medicare Allowed Amount |
159422.58 |
Total Medicare Payment Amount |
112917.51 |
Total Medicare Standardized Payment Amount |
112441.93 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
1483 |
Number Of Medicare Beneficiaries With Drug Services |
177 |
Total Drug Submitted ChargeAmount |
7341.2 |
Total Drug Medicare AllowedAmount |
3312.73 |
Total Drug Medicare PaymentAmount |
3156.06 |
Total Drug Medicare Standardized Payment Amount |
3156.06 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
39 |
Number Of Medical Services |
1913 |
Number Of Medicare Beneficiaries With Medical Services |
332 |
Total Medical Submitted Charge Amount |
192048 |
Total Medical Medicare Allowed Amount |
156109.85 |
Total Medical Medicare Payment Amount |
109761.45 |
Total Medical Medicare Standardized Payment Amount |
109285.87 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
62 |
Number Of Beneficiaries Age 65 to 74 |
146 |
Number Of Beneficiaries Age 75 to 84 |
95 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
202 |
Number Of Male Beneficiaries |
130 |
Number Of Non Hispanic White Beneficiaries |
18 |
Number Of Black or African American Beneficiaries |
52 |
Number Of AsianPacific Islander Beneficiaries |
242 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
52 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
280 |
Percent Of With Atrial Fibrillation |
4 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
4 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
22 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.072 |