National Provider Identifier [NPI]: |
1093887259 |
Last Name Of The Provider |
LEE |
First Name Of The Provider |
MAKAU |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1421 N STATE ST |
Street Address 2 Of The Provider |
SUITE 203 |
City Of The Provider |
JACKSON |
Zip Code Of The Provider |
392021658 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
107 |
Number Of Services |
5898 |
Number Of Medicare Beneficiaries |
498 |
Total Submitted Charge Amount |
670256.7 |
Total Medicare Allowed Amount |
225176.19 |
Total Medicare Payment Amount |
174646.19 |
Total Medicare Standardized Payment Amount |
190147.57 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
2291 |
Number Of Medicare Beneficiaries With Drug Services |
51 |
Total Drug Submitted ChargeAmount |
2064.7 |
Total Drug Medicare AllowedAmount |
703.88 |
Total Drug Medicare PaymentAmount |
557.43 |
Total Drug Medicare Standardized Payment Amount |
557.43 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
102 |
Number Of Medical Services |
3607 |
Number Of Medicare Beneficiaries With Medical Services |
498 |
Total Medical Submitted Charge Amount |
668192 |
Total Medical Medicare Allowed Amount |
224472.31 |
Total Medical Medicare Payment Amount |
174088.76 |
Total Medical Medicare Standardized Payment Amount |
189590.14 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
218 |
Number Of Beneficiaries Age 75 to 84 |
170 |
Number Of Beneficiaries Age Greater 84 |
53 |
Number Of Female Beneficiaries |
263 |
Number Of Male Beneficiaries |
235 |
Number Of Non Hispanic White Beneficiaries |
406 |
Number Of Black or African American Beneficiaries |
|
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 |
434 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
64 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2858 |