National Provider Identifier [NPI]: |
1104896794 |
Last Name Of The Provider |
LAWENDA |
First Name Of The Provider |
BRIAN |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
52 N PECOS RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
HENDERSON |
Zip Code Of The Provider |
890747319 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Radiation Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
44 |
Number Of Services |
4907 |
Number Of Medicare Beneficiaries |
208 |
Total Submitted Charge Amount |
3513049.32 |
Total Medicare Allowed Amount |
1054237.21 |
Total Medicare Payment Amount |
795758.17 |
Total Medicare Standardized Payment Amount |
777667.07 |
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 |
44 |
Number Of Medical Services |
4907 |
Number Of Medicare Beneficiaries With Medical Services |
208 |
Total Medical Submitted Charge Amount |
3513049.32 |
Total Medical Medicare Allowed Amount |
1054237.21 |
Total Medical Medicare Payment Amount |
795758.17 |
Total Medical Medicare Standardized Payment Amount |
777667.07 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
96 |
Number Of Beneficiaries Age 75 to 84 |
70 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
100 |
Number Of Male Beneficiaries |
108 |
Number Of Non Hispanic White Beneficiaries |
173 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
183 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
50 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.6194 |