| National Provider Identifier [NPI]: | 1801886650 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | AUGUSTINE |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4500 SAN PABLO RD S |
| Street Address 2 Of The Provider | |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322241865 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 3285 |
| Number Of Medicare Beneficiaries | 555 |
| Total Submitted Charge Amount | 139898.9 |
| Total Medicare Allowed Amount | 112929.16 |
| Total Medicare Payment Amount | 84217.91 |
| Total Medicare Standardized Payment Amount | 89116.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1986 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 2276.29 |
| Total Drug Medicare AllowedAmount | 1880.53 |
| Total Drug Medicare PaymentAmount | 944.6 |
| Total Drug Medicare Standardized Payment Amount | 944.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 1299 |
| Number Of Medicare Beneficiaries With Medical Services | 554 |
| Total Medical Submitted Charge Amount | 137622.61 |
| Total Medical Medicare Allowed Amount | 111048.63 |
| Total Medical Medicare Payment Amount | 83273.31 |
| Total Medical Medicare Standardized Payment Amount | 88172.34 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 86 |
| Number Of Beneficiaries Age 65 to 74 | 242 |
| Number Of Beneficiaries Age 75 to 84 | 177 |
| Number Of Beneficiaries Age Greater 84 | 50 |
| Number Of Female Beneficiaries | 287 |
| Number Of Male Beneficiaries | 268 |
| Number Of Non Hispanic White Beneficiaries | 475 |
| Number Of Black or African American Beneficiaries | 46 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 502 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 53 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 48 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.952 |