| National Provider Identifier [NPI]: | 1447226410 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1833 2ND AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ANOKA |
| Zip Code Of The Provider | 553032432 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 93 |
| Number Of Services | 2025 |
| Number Of Medicare Beneficiaries | 299 |
| Total Submitted Charge Amount | 178303 |
| Total Medicare Allowed Amount | 62136.57 |
| Total Medicare Payment Amount | 44930.99 |
| Total Medicare Standardized Payment Amount | 45705.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 706 |
| Number Of Medicare Beneficiaries With Drug Services | 103 |
| Total Drug Submitted ChargeAmount | 3048 |
| Total Drug Medicare AllowedAmount | 1280.22 |
| Total Drug Medicare PaymentAmount | 1018.7 |
| Total Drug Medicare Standardized Payment Amount | 1018.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 83 |
| Number Of Medical Services | 1319 |
| Number Of Medicare Beneficiaries With Medical Services | 299 |
| Total Medical Submitted Charge Amount | 175255 |
| Total Medical Medicare Allowed Amount | 60856.35 |
| Total Medical Medicare Payment Amount | 43912.29 |
| Total Medical Medicare Standardized Payment Amount | 44686.7 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 88 |
| Number Of Beneficiaries Age 65 to 74 | 94 |
| Number Of Beneficiaries Age 75 to 84 | 64 |
| Number Of Beneficiaries Age Greater 84 | 53 |
| Number Of Female Beneficiaries | 154 |
| Number Of Male Beneficiaries | 145 |
| Number Of Non Hispanic White Beneficiaries | 288 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 203 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 96 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 29 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1184 |