| National Provider Identifier [NPI]: | 1568474062 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7320 216TH ST SW |
| Street Address 2 Of The Provider | SUITE 320 |
| City Of The Provider | EDMONDS |
| Zip Code Of The Provider | 980268006 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 935 |
| Number Of Medicare Beneficiaries | 204 |
| Total Submitted Charge Amount | 192816 |
| Total Medicare Allowed Amount | 69473.65 |
| Total Medicare Payment Amount | 51986.34 |
| Total Medicare Standardized Payment Amount | 52760.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 272 |
| Number Of Medicare Beneficiaries With Drug Services | 55 |
| Total Drug Submitted ChargeAmount | 29652 |
| Total Drug Medicare AllowedAmount | 8566.53 |
| Total Drug Medicare PaymentAmount | 6704.92 |
| Total Drug Medicare Standardized Payment Amount | 6704.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 663 |
| Number Of Medicare Beneficiaries With Medical Services | 204 |
| Total Medical Submitted Charge Amount | 163164 |
| Total Medical Medicare Allowed Amount | 60907.12 |
| Total Medical Medicare Payment Amount | 45281.42 |
| Total Medical Medicare Standardized Payment Amount | 46055.78 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 74 |
| Number Of Beneficiaries Age 75 to 84 | 77 |
| Number Of Beneficiaries Age Greater 84 | 32 |
| Number Of Female Beneficiaries | 127 |
| Number Of Male Beneficiaries | 77 |
| Number Of Non Hispanic White Beneficiaries | 188 |
| 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 | 180 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 24 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0128 |