| National Provider Identifier [NPI]: | 1790906816 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | DAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 408 S BEACH BLVD |
| Street Address 2 Of The Provider | SUITE 106 |
| City Of The Provider | ANAHEIM |
| Zip Code Of The Provider | 928041853 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 121 |
| Number Of Services | 10470 |
| Number Of Medicare Beneficiaries | 2005 |
| Total Submitted Charge Amount | 894115 |
| Total Medicare Allowed Amount | 352920.67 |
| Total Medicare Payment Amount | 277394.76 |
| Total Medicare Standardized Payment Amount | 237907.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 6900 |
| Number Of Medicare Beneficiaries With Drug Services | 74 |
| Total Drug Submitted ChargeAmount | 25500 |
| Total Drug Medicare AllowedAmount | 7944.32 |
| Total Drug Medicare PaymentAmount | 6228.23 |
| Total Drug Medicare Standardized Payment Amount | 6228.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 119 |
| Number Of Medical Services | 3570 |
| Number Of Medicare Beneficiaries With Medical Services | 2005 |
| Total Medical Submitted Charge Amount | 868615 |
| Total Medical Medicare Allowed Amount | 344976.35 |
| Total Medical Medicare Payment Amount | 271166.53 |
| Total Medical Medicare Standardized Payment Amount | 231679.1 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 306 |
| Number Of Beneficiaries Age 65 to 74 | 853 |
| Number Of Beneficiaries Age 75 to 84 | 596 |
| Number Of Beneficiaries Age Greater 84 | 250 |
| Number Of Female Beneficiaries | 1455 |
| Number Of Male Beneficiaries | 550 |
| Number Of Non Hispanic White Beneficiaries | 785 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 522 |
| Number Of Hispanic Beneficiaries | 617 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 46 |
| Number Of Beneficiaries With Medicare Only Entitlement | 986 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1019 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.2639 |