National Provider Identifier [NPI]: |
1376633149 |
Last Name Of The Provider |
LEE |
First Name Of The Provider |
WES |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3555 ROUND BARN CIR |
Street Address 2 Of The Provider |
|
City Of The Provider |
SANTA ROSA |
Zip Code Of The Provider |
954031757 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Medical Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
96 |
Number Of Services |
27654 |
Number Of Medicare Beneficiaries |
655 |
Total Submitted Charge Amount |
1086245 |
Total Medicare Allowed Amount |
554397.22 |
Total Medicare Payment Amount |
431537.01 |
Total Medicare Standardized Payment Amount |
425147.79 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
49 |
Number Of Drug Services |
24558 |
Number Of Medicare Beneficiaries With Drug Services |
127 |
Total Drug Submitted ChargeAmount |
712399 |
Total Drug Medicare AllowedAmount |
352070.81 |
Total Drug Medicare PaymentAmount |
274880.54 |
Total Drug Medicare Standardized Payment Amount |
274880.54 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
47 |
Number Of Medical Services |
3096 |
Number Of Medicare Beneficiaries With Medical Services |
655 |
Total Medical Submitted Charge Amount |
373846 |
Total Medical Medicare Allowed Amount |
202326.41 |
Total Medical Medicare Payment Amount |
156656.47 |
Total Medical Medicare Standardized Payment Amount |
150267.25 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
76 |
Number Of Beneficiaries Age 65 to 74 |
262 |
Number Of Beneficiaries Age 75 to 84 |
202 |
Number Of Beneficiaries Age Greater 84 |
115 |
Number Of Female Beneficiaries |
334 |
Number Of Male Beneficiaries |
321 |
Number Of Non Hispanic White Beneficiaries |
570 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
12 |
Number Of Hispanic Beneficiaries |
45 |
Number Of American Indian Alaska Native Beneficiaries |
12 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
508 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
147 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
47 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
2.0652 |