| National Provider Identifier [NPI]: | 1285746578 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | ANDY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 388 E HWY 67 |
| Street Address 2 Of The Provider | |
| City Of The Provider | DUNCANVILLE |
| Zip Code Of The Provider | 751374159 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 7232 |
| Number Of Medicare Beneficiaries | 1821 |
| Total Submitted Charge Amount | 2417405 |
| Total Medicare Allowed Amount | 883315.24 |
| Total Medicare Payment Amount | 642682.82 |
| Total Medicare Standardized Payment Amount | 644488.35 |
| 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 | 45 |
| Number Of Medical Services | 7232 |
| Number Of Medicare Beneficiaries With Medical Services | 1821 |
| Total Medical Submitted Charge Amount | 2417405 |
| Total Medical Medicare Allowed Amount | 883315.24 |
| Total Medical Medicare Payment Amount | 642682.82 |
| Total Medical Medicare Standardized Payment Amount | 644488.35 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 94 |
| Number Of Beneficiaries Age 65 to 74 | 813 |
| Number Of Beneficiaries Age 75 to 84 | 629 |
| Number Of Beneficiaries Age Greater 84 | 285 |
| Number Of Female Beneficiaries | 1174 |
| Number Of Male Beneficiaries | 647 |
| Number Of Non Hispanic White Beneficiaries | 1119 |
| Number Of Black or African American Beneficiaries | 538 |
| Number Of AsianPacific Islander Beneficiaries | 28 |
| Number Of Hispanic Beneficiaries | 116 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1711 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 110 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1418 |