National Provider Identifier [NPI]: |
1245234111 |
Last Name Of The Provider |
LEE |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6400 DUTCHMANS PKWY |
Street Address 2 Of The Provider |
STE 250 |
City Of The Provider |
LOUISVILLE |
Zip Code Of The Provider |
402053340 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
3338 |
Number Of Medicare Beneficiaries |
802 |
Total Submitted Charge Amount |
461328 |
Total Medicare Allowed Amount |
274148.57 |
Total Medicare Payment Amount |
207368.81 |
Total Medicare Standardized Payment Amount |
222648.15 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
160 |
Number Of Beneficiaries Age 65 to 74 |
242 |
Number Of Beneficiaries Age 75 to 84 |
268 |
Number Of Beneficiaries Age Greater 84 |
132 |
Number Of Female Beneficiaries |
407 |
Number Of Male Beneficiaries |
395 |
Number Of Non Hispanic White Beneficiaries |
644 |
Number Of Black or African American Beneficiaries |
139 |
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 |
616 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
186 |
Percent Of With Atrial Fibrillation |
32 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
57 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
58 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
3.5852 |