| National Provider Identifier [NPI]: | 1306817077 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | TERRENCE |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1811 SPRINGFIELD AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW PROVIDENCE |
| Zip Code Of The Provider | 079741041 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 173 |
| Number Of Services | 8981 |
| Number Of Medicare Beneficiaries | 3657 |
| Total Submitted Charge Amount | 1290881.5 |
| Total Medicare Allowed Amount | 324589.89 |
| Total Medicare Payment Amount | 248112.28 |
| Total Medicare Standardized Payment Amount | 227084.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 3196 |
| Number Of Medicare Beneficiaries With Drug Services | 95 |
| Total Drug Submitted ChargeAmount | 25960.5 |
| Total Drug Medicare AllowedAmount | 11400.9 |
| Total Drug Medicare PaymentAmount | 8898.97 |
| Total Drug Medicare Standardized Payment Amount | 8898.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 170 |
| Number Of Medical Services | 5785 |
| Number Of Medicare Beneficiaries With Medical Services | 3657 |
| Total Medical Submitted Charge Amount | 1264921 |
| Total Medical Medicare Allowed Amount | 313188.99 |
| Total Medical Medicare Payment Amount | 239213.31 |
| Total Medical Medicare Standardized Payment Amount | 218185.97 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 409 |
| Number Of Beneficiaries Age 65 to 74 | 1311 |
| Number Of Beneficiaries Age 75 to 84 | 1123 |
| Number Of Beneficiaries Age Greater 84 | 814 |
| Number Of Female Beneficiaries | 2194 |
| Number Of Male Beneficiaries | 1463 |
| Number Of Non Hispanic White Beneficiaries | 2886 |
| Number Of Black or African American Beneficiaries | 405 |
| Number Of AsianPacific Islander Beneficiaries | 63 |
| Number Of Hispanic Beneficiaries | 230 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 73 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3194 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 463 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.6666 |