National Provider Identifier [NPI]: |
1063679256 |
Last Name Of The Provider |
MILLER |
First Name Of The Provider |
LEE |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2000 TYBEE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAKE CHARLES |
Zip Code Of The Provider |
706054171 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
74 |
Number Of Services |
2261 |
Number Of Medicare Beneficiaries |
552 |
Total Submitted Charge Amount |
1731332 |
Total Medicare Allowed Amount |
616846.26 |
Total Medicare Payment Amount |
474460 |
Total Medicare Standardized Payment Amount |
450217.21 |
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 |
74 |
Number Of Medical Services |
2261 |
Number Of Medicare Beneficiaries With Medical Services |
552 |
Total Medical Submitted Charge Amount |
1731332 |
Total Medical Medicare Allowed Amount |
616846.26 |
Total Medical Medicare Payment Amount |
474460 |
Total Medical Medicare Standardized Payment Amount |
450217.21 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
217 |
Number Of Beneficiaries Age 75 to 84 |
210 |
Number Of Beneficiaries Age Greater 84 |
108 |
Number Of Female Beneficiaries |
187 |
Number Of Male Beneficiaries |
365 |
Number Of Non Hispanic White Beneficiaries |
536 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
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 |
512 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
40 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.143 |