| National Provider Identifier [NPI]: | 1891722997 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | THOMAS |
| 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 | 5528 E LA PALMA AVE |
| Street Address 2 Of The Provider | SUITE 4-A |
| City Of The Provider | ANAHEIM |
| Zip Code Of The Provider | 928072115 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 192 |
| Number Of Services | 3358 |
| Number Of Medicare Beneficiaries | 1814 |
| Total Submitted Charge Amount | 464380 |
| Total Medicare Allowed Amount | 110841.39 |
| Total Medicare Payment Amount | 82807.2 |
| Total Medicare Standardized Payment Amount | 79725.32 |
| 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 | 192 |
| Number Of Medical Services | 3358 |
| Number Of Medicare Beneficiaries With Medical Services | 1814 |
| Total Medical Submitted Charge Amount | 464380 |
| Total Medical Medicare Allowed Amount | 110841.39 |
| Total Medical Medicare Payment Amount | 82807.2 |
| Total Medical Medicare Standardized Payment Amount | 79725.32 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 245 |
| Number Of Beneficiaries Age 65 to 74 | 629 |
| Number Of Beneficiaries Age 75 to 84 | 537 |
| Number Of Beneficiaries Age Greater 84 | 403 |
| Number Of Female Beneficiaries | 1128 |
| Number Of Male Beneficiaries | 686 |
| Number Of Non Hispanic White Beneficiaries | 1214 |
| Number Of Black or African American Beneficiaries | 86 |
| Number Of AsianPacific Islander Beneficiaries | 155 |
| Number Of Hispanic Beneficiaries | 312 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1154 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 660 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.9236 |