National Provider Identifier [NPI]: |
1073587820 |
Last Name Of The Provider |
LEE |
First Name Of The Provider |
RONALD |
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 |
148 EAST AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
NORWALK |
Zip Code Of The Provider |
068515721 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
148 |
Number Of Services |
2762 |
Number Of Medicare Beneficiaries |
1887 |
Total Submitted Charge Amount |
599494 |
Total Medicare Allowed Amount |
144319.92 |
Total Medicare Payment Amount |
106861.76 |
Total Medicare Standardized Payment Amount |
102592.41 |
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 |
148 |
Number Of Medical Services |
2762 |
Number Of Medicare Beneficiaries With Medical Services |
1887 |
Total Medical Submitted Charge Amount |
599494 |
Total Medical Medicare Allowed Amount |
144319.92 |
Total Medical Medicare Payment Amount |
106861.76 |
Total Medical Medicare Standardized Payment Amount |
102592.41 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
198 |
Number Of Beneficiaries Age 65 to 74 |
558 |
Number Of Beneficiaries Age 75 to 84 |
583 |
Number Of Beneficiaries Age Greater 84 |
548 |
Number Of Female Beneficiaries |
1109 |
Number Of Male Beneficiaries |
778 |
Number Of Non Hispanic White Beneficiaries |
1558 |
Number Of Black or African American Beneficiaries |
171 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
96 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
36 |
Number Of Beneficiaries With Medicare Only Entitlement |
1349 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
538 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
1.7392 |