National Provider Identifier [NPI]: |
1871849471 |
Last Name Of The Provider |
LEE |
First Name Of The Provider |
MICHELE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1501 TROUSDALE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
BURLINGAME |
Zip Code Of The Provider |
940104506 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
1259 |
Number Of Medicare Beneficiaries |
395 |
Total Submitted Charge Amount |
452765 |
Total Medicare Allowed Amount |
156789.07 |
Total Medicare Payment Amount |
120544.34 |
Total Medicare Standardized Payment Amount |
106931.88 |
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 |
1259 |
Number Of Medicare Beneficiaries With Medical Services |
395 |
Total Medical Submitted Charge Amount |
452765 |
Total Medical Medicare Allowed Amount |
156789.07 |
Total Medical Medicare Payment Amount |
120544.34 |
Total Medical Medicare Standardized Payment Amount |
106931.88 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
86 |
Number Of Beneficiaries Age 75 to 84 |
127 |
Number Of Beneficiaries Age Greater 84 |
149 |
Number Of Female Beneficiaries |
214 |
Number Of Male Beneficiaries |
181 |
Number Of Non Hispanic White Beneficiaries |
294 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
49 |
Number Of Hispanic Beneficiaries |
35 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
334 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
61 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.2107 |