| National Provider Identifier [NPI]: | 1063699460 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | PHILIP |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 141 W 22ND ST STE 109 |
| Street Address 2 Of The Provider | |
| City Of The Provider | ANDERSON |
| Zip Code Of The Provider | 460164315 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 5472 |
| Number Of Medicare Beneficiaries | 2284 |
| Total Submitted Charge Amount | 967023 |
| Total Medicare Allowed Amount | 230168.93 |
| Total Medicare Payment Amount | 168298.26 |
| Total Medicare Standardized Payment Amount | 171275.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 5472 |
| Number Of Medicare Beneficiaries With Medical Services | 2284 |
| Total Medical Submitted Charge Amount | 967023 |
| Total Medical Medicare Allowed Amount | 230168.93 |
| Total Medical Medicare Payment Amount | 168298.26 |
| Total Medical Medicare Standardized Payment Amount | 171275.61 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 390 |
| Number Of Beneficiaries Age 65 to 74 | 797 |
| Number Of Beneficiaries Age 75 to 84 | 698 |
| Number Of Beneficiaries Age Greater 84 | 399 |
| Number Of Female Beneficiaries | 1258 |
| Number Of Male Beneficiaries | 1026 |
| Number Of Non Hispanic White Beneficiaries | 2115 |
| Number Of Black or African American Beneficiaries | 135 |
| 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 | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1752 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 532 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5696 |