National Provider Identifier [NPI]: |
1184642175 |
Last Name Of The Provider |
LEE |
First Name Of The Provider |
SUNGHOON |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1229 E SEMINOLE ST |
Street Address 2 Of The Provider |
SUITE 220 |
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
658042227 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurosurgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
76 |
Number Of Services |
808 |
Number Of Medicare Beneficiaries |
364 |
Total Submitted Charge Amount |
1533324.1 |
Total Medicare Allowed Amount |
312192.49 |
Total Medicare Payment Amount |
243199.5 |
Total Medicare Standardized Payment Amount |
252063.47 |
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 |
76 |
Number Of Medical Services |
808 |
Number Of Medicare Beneficiaries With Medical Services |
364 |
Total Medical Submitted Charge Amount |
1533324.1 |
Total Medical Medicare Allowed Amount |
312192.49 |
Total Medical Medicare Payment Amount |
243199.5 |
Total Medical Medicare Standardized Payment Amount |
252063.47 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
78 |
Number Of Beneficiaries Age 65 to 74 |
161 |
Number Of Beneficiaries Age 75 to 84 |
95 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
187 |
Number Of Male Beneficiaries |
177 |
Number Of Non Hispanic White Beneficiaries |
349 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
295 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
69 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
72 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
1.169 |