National Provider Identifier [NPI]: |
1306933114 |
Last Name Of The Provider |
LEE |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6900 GEORGIA AVE NW |
Street Address 2 Of The Provider |
|
City Of The Provider |
WASHINGTON |
Zip Code Of The Provider |
203070003 |
State Code Of The Provider |
DC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
477 |
Number Of Medicare Beneficiaries |
418 |
Total Submitted Charge Amount |
479214 |
Total Medicare Allowed Amount |
67577.94 |
Total Medicare Payment Amount |
52134.08 |
Total Medicare Standardized Payment Amount |
50049.26 |
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 |
21 |
Number Of Medical Services |
477 |
Number Of Medicare Beneficiaries With Medical Services |
418 |
Total Medical Submitted Charge Amount |
479214 |
Total Medical Medicare Allowed Amount |
67577.94 |
Total Medical Medicare Payment Amount |
52134.08 |
Total Medical Medicare Standardized Payment Amount |
50049.26 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
110 |
Number Of Beneficiaries Age 65 to 74 |
139 |
Number Of Beneficiaries Age 75 to 84 |
80 |
Number Of Beneficiaries Age Greater 84 |
89 |
Number Of Female Beneficiaries |
256 |
Number Of Male Beneficiaries |
162 |
Number Of Non Hispanic White Beneficiaries |
299 |
Number Of Black or African American Beneficiaries |
78 |
Number Of AsianPacific Islander Beneficiaries |
|
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 |
307 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
111 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
1.738 |