| National Provider Identifier [NPI]: | 1427287408 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | EARL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2020 CAPITOL ST NE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SALEM |
| Zip Code Of The Provider | 973010644 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 176 |
| Number Of Services | 6585 |
| Number Of Medicare Beneficiaries | 416 |
| Total Submitted Charge Amount | 464400.5 |
| Total Medicare Allowed Amount | 185361.11 |
| Total Medicare Payment Amount | 142224.47 |
| Total Medicare Standardized Payment Amount | 146632.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 747 |
| Number Of Medicare Beneficiaries With Drug Services | 112 |
| Total Drug Submitted ChargeAmount | 6598 |
| Total Drug Medicare AllowedAmount | 4367.42 |
| Total Drug Medicare PaymentAmount | 4238.25 |
| Total Drug Medicare Standardized Payment Amount | 4238.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 163 |
| Number Of Medical Services | 5838 |
| Number Of Medicare Beneficiaries With Medical Services | 416 |
| Total Medical Submitted Charge Amount | 457802.5 |
| Total Medical Medicare Allowed Amount | 180993.69 |
| Total Medical Medicare Payment Amount | 137986.22 |
| Total Medical Medicare Standardized Payment Amount | 142394.44 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 117 |
| Number Of Beneficiaries Age 65 to 74 | 162 |
| Number Of Beneficiaries Age 75 to 84 | 84 |
| Number Of Beneficiaries Age Greater 84 | 53 |
| Number Of Female Beneficiaries | 256 |
| Number Of Male Beneficiaries | 160 |
| Number Of Non Hispanic White Beneficiaries | 377 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 280 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 136 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.3347 |