National Provider Identifier [NPI]: |
1447499199 |
Last Name Of The Provider |
LEE |
First Name Of The Provider |
INSUN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2336 SANTA MONICA BLVD |
Street Address 2 Of The Provider |
SUITE 208 |
City Of The Provider |
SANTA MONICA |
Zip Code Of The Provider |
904042095 |
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 |
44 |
Number Of Services |
1048 |
Number Of Medicare Beneficiaries |
433 |
Total Submitted Charge Amount |
1520495 |
Total Medicare Allowed Amount |
131800.34 |
Total Medicare Payment Amount |
103275.78 |
Total Medicare Standardized Payment Amount |
103492.31 |
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 |
1048 |
Number Of Medicare Beneficiaries With Medical Services |
433 |
Total Medical Submitted Charge Amount |
1520495 |
Total Medical Medicare Allowed Amount |
131800.34 |
Total Medical Medicare Payment Amount |
103275.78 |
Total Medical Medicare Standardized Payment Amount |
103492.31 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
78 |
Number Of Beneficiaries Age 65 to 74 |
178 |
Number Of Beneficiaries Age 75 to 84 |
127 |
Number Of Beneficiaries Age Greater 84 |
50 |
Number Of Female Beneficiaries |
283 |
Number Of Male Beneficiaries |
150 |
Number Of Non Hispanic White Beneficiaries |
343 |
Number Of Black or African American Beneficiaries |
39 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
29 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
354 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
79 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1968 |