| National Provider Identifier [NPI]: | 1205847431 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | ALAN |
| 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 | 1304 15TH STREET |
| Street Address 2 Of The Provider | #400 |
| City Of The Provider | SANTA MONICA |
| Zip Code Of The Provider | 90404 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 850 |
| Number Of Medicare Beneficiaries | 140 |
| Total Submitted Charge Amount | 243216.89 |
| Total Medicare Allowed Amount | 82060.81 |
| Total Medicare Payment Amount | 57771.74 |
| Total Medicare Standardized Payment Amount | 53025.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 177 |
| Number Of Medicare Beneficiaries With Drug Services | 74 |
| Total Drug Submitted ChargeAmount | 5497.89 |
| Total Drug Medicare AllowedAmount | 1481.06 |
| Total Drug Medicare PaymentAmount | 1420.09 |
| Total Drug Medicare Standardized Payment Amount | 1420.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 673 |
| Number Of Medicare Beneficiaries With Medical Services | 140 |
| Total Medical Submitted Charge Amount | 237719 |
| Total Medical Medicare Allowed Amount | 80579.75 |
| Total Medical Medicare Payment Amount | 56351.65 |
| Total Medical Medicare Standardized Payment Amount | 51605.13 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 64 |
| Number Of Beneficiaries Age 75 to 84 | 26 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 71 |
| Number Of Male Beneficiaries | 69 |
| Number Of Non Hispanic White Beneficiaries | 71 |
| Number Of Black or African American Beneficiaries | 13 |
| Number Of AsianPacific Islander Beneficiaries | 23 |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 87 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 53 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0555 |