| National Provider Identifier [NPI]: | 1386803633 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | JULIAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 763 E US HIGHWAY 80 STE 100 |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORNEY |
| Zip Code Of The Provider | 751268675 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 117 |
| Number Of Medicare Beneficiaries | 21 |
| Total Submitted Charge Amount | 9692 |
| Total Medicare Allowed Amount | 4512.58 |
| Total Medicare Payment Amount | 2607.51 |
| Total Medicare Standardized Payment Amount | 3499.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 52 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 647 |
| Total Drug Medicare AllowedAmount | 100.98 |
| Total Drug Medicare PaymentAmount | 94.17 |
| Total Drug Medicare Standardized Payment Amount | 94.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 12 |
| Number Of Medical Services | 65 |
| Number Of Medicare Beneficiaries With Medical Services | 21 |
| Total Medical Submitted Charge Amount | 9045 |
| Total Medical Medicare Allowed Amount | 4411.6 |
| Total Medical Medicare Payment Amount | 2513.34 |
| Total Medical Medicare Standardized Payment Amount | 3405.42 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 0 |
| Percent Of With Alzheimers Disease or Dementia | 0 |
| Percent Of With Asthma | 0 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | |
| Percent Of With Hypertension | |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.614 |