National Provider Identifier [NPI]: |
1477666105 |
Last Name Of The Provider |
LEE |
First Name Of The Provider |
BOCK |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2131 W 3RD ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
LOS ANGELES |
Zip Code Of The Provider |
900571901 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
64 |
Number Of Services |
326 |
Number Of Medicare Beneficiaries |
273 |
Total Submitted Charge Amount |
406939.52 |
Total Medicare Allowed Amount |
93968.14 |
Total Medicare Payment Amount |
73555.51 |
Total Medicare Standardized Payment Amount |
70923.25 |
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 |
64 |
Number Of Medical Services |
326 |
Number Of Medicare Beneficiaries With Medical Services |
273 |
Total Medical Submitted Charge Amount |
406939.52 |
Total Medical Medicare Allowed Amount |
93968.14 |
Total Medical Medicare Payment Amount |
73555.51 |
Total Medical Medicare Standardized Payment Amount |
70923.25 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
54 |
Number Of Beneficiaries Age 65 to 74 |
98 |
Number Of Beneficiaries Age 75 to 84 |
88 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
140 |
Number Of Male Beneficiaries |
133 |
Number Of Non Hispanic White Beneficiaries |
42 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
101 |
Number Of Hispanic Beneficiaries |
86 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
64 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
209 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
61 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
3.114 |