National Provider Identifier [NPI]: |
1972511970 |
Last Name Of The Provider |
LEE |
First Name Of The Provider |
NENG |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
NURSE PRACTITIONER |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5066 N FRESNO ST |
Street Address 2 Of The Provider |
SUITE 111 |
City Of The Provider |
FRESNO |
Zip Code Of The Provider |
937107615 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
3809 |
Number Of Medicare Beneficiaries |
367 |
Total Submitted Charge Amount |
271652 |
Total Medicare Allowed Amount |
177646.23 |
Total Medicare Payment Amount |
121604.08 |
Total Medicare Standardized Payment Amount |
137874.05 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
331 |
Number Of Medicare Beneficiaries With Drug Services |
237 |
Total Drug Submitted ChargeAmount |
13834 |
Total Drug Medicare AllowedAmount |
10010.89 |
Total Drug Medicare PaymentAmount |
9794.21 |
Total Drug Medicare Standardized Payment Amount |
9794.21 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
31 |
Number Of Medical Services |
3478 |
Number Of Medicare Beneficiaries With Medical Services |
367 |
Total Medical Submitted Charge Amount |
257818 |
Total Medical Medicare Allowed Amount |
167635.34 |
Total Medical Medicare Payment Amount |
111809.87 |
Total Medical Medicare Standardized Payment Amount |
128079.84 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
86 |
Number Of Beneficiaries Age 65 to 74 |
128 |
Number Of Beneficiaries Age 75 to 84 |
103 |
Number Of Beneficiaries Age Greater 84 |
50 |
Number Of Female Beneficiaries |
210 |
Number Of Male Beneficiaries |
157 |
Number Of Non Hispanic White Beneficiaries |
21 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
320 |
Number Of Hispanic Beneficiaries |
15 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
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 |
7 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
5 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
47 |
Percent Of With Ischemic Heart Disease |
16 |
Percent Of With Osteoporosis |
3 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
19 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.1417 |