| National Provider Identifier [NPI]: | 1811915143 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 736 CAMBRIDGE ST |
| Street Address 2 Of The Provider | RADIOLOGY CMP 4 |
| City Of The Provider | BOSTON |
| Zip Code Of The Provider | 021352907 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 211 |
| Number Of Services | 3237 |
| Number Of Medicare Beneficiaries | 1730 |
| Total Submitted Charge Amount | 401849 |
| Total Medicare Allowed Amount | 116565.92 |
| Total Medicare Payment Amount | 89860.62 |
| Total Medicare Standardized Payment Amount | 87085.64 |
| 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 | 211 |
| Number Of Medical Services | 3237 |
| Number Of Medicare Beneficiaries With Medical Services | 1730 |
| Total Medical Submitted Charge Amount | 401849 |
| Total Medical Medicare Allowed Amount | 116565.92 |
| Total Medical Medicare Payment Amount | 89860.62 |
| Total Medical Medicare Standardized Payment Amount | 87085.64 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 292 |
| Number Of Beneficiaries Age 65 to 74 | 540 |
| Number Of Beneficiaries Age 75 to 84 | 536 |
| Number Of Beneficiaries Age Greater 84 | 362 |
| Number Of Female Beneficiaries | 1005 |
| Number Of Male Beneficiaries | 725 |
| Number Of Non Hispanic White Beneficiaries | 1430 |
| Number Of Black or African American Beneficiaries | 90 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 67 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 77 |
| Number Of Beneficiaries With Medicare Only Entitlement | 973 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 757 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.0782 |