| National Provider Identifier [NPI]: | 1083658587 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | HASOON |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4853 GALAXY PKWY |
| Street Address 2 Of The Provider | SUITE I |
| City Of The Provider | CLEVELAND |
| Zip Code Of The Provider | 441285973 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 143 |
| Number Of Services | 3890 |
| Number Of Medicare Beneficiaries | 2668 |
| Total Submitted Charge Amount | 574692.5 |
| Total Medicare Allowed Amount | 104607.9 |
| Total Medicare Payment Amount | 82721.69 |
| Total Medicare Standardized Payment Amount | 84820.61 |
| 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 | 143 |
| Number Of Medical Services | 3890 |
| Number Of Medicare Beneficiaries With Medical Services | 2668 |
| Total Medical Submitted Charge Amount | 574692.5 |
| Total Medical Medicare Allowed Amount | 104607.9 |
| Total Medical Medicare Payment Amount | 82721.69 |
| Total Medical Medicare Standardized Payment Amount | 84820.61 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 312 |
| Number Of Beneficiaries Age 65 to 74 | 858 |
| Number Of Beneficiaries Age 75 to 84 | 869 |
| Number Of Beneficiaries Age Greater 84 | 629 |
| Number Of Female Beneficiaries | 1762 |
| Number Of Male Beneficiaries | 906 |
| Number Of Non Hispanic White Beneficiaries | 2524 |
| Number Of Black or African American Beneficiaries | 64 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 29 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2160 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 508 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6373 |