National Provider Identifier [NPI]: |
1508953837 |
Last Name Of The Provider |
LEE |
First Name Of The Provider |
JUN |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
DC |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
966 S WESTERN AVENUE |
Street Address 2 Of The Provider |
STE 201 |
City Of The Provider |
LOS ANGELES |
Zip Code Of The Provider |
90006 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Chiropractic |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
2 |
Number Of Services |
2431 |
Number Of Medicare Beneficiaries |
211 |
Total Submitted Charge Amount |
122175 |
Total Medicare Allowed Amount |
106737.53 |
Total Medicare Payment Amount |
82962.87 |
Total Medicare Standardized Payment Amount |
78041.39 |
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 |
2 |
Number Of Medical Services |
2431 |
Number Of Medicare Beneficiaries With Medical Services |
211 |
Total Medical Submitted Charge Amount |
122175 |
Total Medical Medicare Allowed Amount |
106737.53 |
Total Medical Medicare Payment Amount |
82962.87 |
Total Medical Medicare Standardized Payment Amount |
78041.39 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
100 |
Number Of Beneficiaries Age 75 to 84 |
83 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
117 |
Number Of Male Beneficiaries |
94 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
192 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
27 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
184 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
70 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
21 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
73 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2328 |