| National Provider Identifier [NPI]: | 1639403462 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7331 GLADIOLUS DRIVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 33908 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 2557 |
| Number Of Medicare Beneficiaries | 639 |
| Total Submitted Charge Amount | 366108.49 |
| Total Medicare Allowed Amount | 332888.02 |
| Total Medicare Payment Amount | 259534.96 |
| Total Medicare Standardized Payment Amount | 242796.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 29 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 2010.83 |
| Total Drug Medicare AllowedAmount | 1989.25 |
| Total Drug Medicare PaymentAmount | 1559.53 |
| Total Drug Medicare Standardized Payment Amount | 1559.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 2528 |
| Number Of Medicare Beneficiaries With Medical Services | 639 |
| Total Medical Submitted Charge Amount | 364097.66 |
| Total Medical Medicare Allowed Amount | 330898.77 |
| Total Medical Medicare Payment Amount | 257975.43 |
| Total Medical Medicare Standardized Payment Amount | 241236.86 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 301 |
| Number Of Beneficiaries Age 75 to 84 | 231 |
| Number Of Beneficiaries Age Greater 84 | 85 |
| Number Of Female Beneficiaries | 261 |
| Number Of Male Beneficiaries | 378 |
| Number Of Non Hispanic White Beneficiaries | 611 |
| 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 | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 621 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0112 |