National Provider Identifier [NPI]: |
1679641344 |
Last Name Of The Provider |
LU |
First Name Of The Provider |
STEVEN |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11719 NE 95TH ST STE F |
Street Address 2 Of The Provider |
|
City Of The Provider |
VANCOUVER |
Zip Code Of The Provider |
986822444 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
670 |
Number Of Medicare Beneficiaries |
61 |
Total Submitted Charge Amount |
133280.1 |
Total Medicare Allowed Amount |
48922.28 |
Total Medicare Payment Amount |
34452.57 |
Total Medicare Standardized Payment Amount |
35982.21 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
29 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
476.5 |
Total Drug Medicare AllowedAmount |
156.92 |
Total Drug Medicare PaymentAmount |
144.96 |
Total Drug Medicare Standardized Payment Amount |
144.96 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
641 |
Number Of Medicare Beneficiaries With Medical Services |
61 |
Total Medical Submitted Charge Amount |
132803.6 |
Total Medical Medicare Allowed Amount |
48765.36 |
Total Medical Medicare Payment Amount |
34307.61 |
Total Medical Medicare Standardized Payment Amount |
35837.25 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
20 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
30 |
Number Of Male Beneficiaries |
31 |
Number Of Non Hispanic White Beneficiaries |
49 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
0 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
33 |
Percent Of With Hypertension |
30 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.882 |