| National Provider Identifier [NPI]: | 1306055678 |
| Last Name Of The Provider | MARSHALL |
| First Name Of The Provider | LEE |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1400 E BOULDER ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | COLORADO SPRINGS |
| Zip Code Of The Provider | 809095533 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 216 |
| Number Of Services | 13852 |
| Number Of Medicare Beneficiaries | 3248 |
| Total Submitted Charge Amount | 1418640.94 |
| Total Medicare Allowed Amount | 437201.53 |
| Total Medicare Payment Amount | 338105.74 |
| Total Medicare Standardized Payment Amount | 342199.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 8562 |
| Number Of Medicare Beneficiaries With Drug Services | 268 |
| Total Drug Submitted ChargeAmount | 9563.12 |
| Total Drug Medicare AllowedAmount | 6659.64 |
| Total Drug Medicare PaymentAmount | 5183.18 |
| Total Drug Medicare Standardized Payment Amount | 5183.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 214 |
| Number Of Medical Services | 5290 |
| Number Of Medicare Beneficiaries With Medical Services | 3248 |
| Total Medical Submitted Charge Amount | 1409077.82 |
| Total Medical Medicare Allowed Amount | 430541.89 |
| Total Medical Medicare Payment Amount | 332922.56 |
| Total Medical Medicare Standardized Payment Amount | 337016.71 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 471 |
| Number Of Beneficiaries Age 65 to 74 | 1407 |
| Number Of Beneficiaries Age 75 to 84 | 928 |
| Number Of Beneficiaries Age Greater 84 | 442 |
| Number Of Female Beneficiaries | 2002 |
| Number Of Male Beneficiaries | 1246 |
| Number Of Non Hispanic White Beneficiaries | 2795 |
| Number Of Black or African American Beneficiaries | 136 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 200 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 60 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2830 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 418 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.3695 |