| National Provider Identifier [NPI]: | 1740208768 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | HO |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2722 MERRILEE DR |
| Street Address 2 Of The Provider | SUITE 230 |
| City Of The Provider | FAIRFAX |
| Zip Code Of The Provider | 220314400 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 90 |
| Number Of Services | 10797 |
| Number Of Medicare Beneficiaries | 2206 |
| Total Submitted Charge Amount | 1381832.98 |
| Total Medicare Allowed Amount | 257492.3 |
| Total Medicare Payment Amount | 194292.94 |
| Total Medicare Standardized Payment Amount | 180049.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 7782 |
| Number Of Medicare Beneficiaries With Drug Services | 86 |
| Total Drug Submitted ChargeAmount | 7334.98 |
| Total Drug Medicare AllowedAmount | 2331.51 |
| Total Drug Medicare PaymentAmount | 1773.84 |
| Total Drug Medicare Standardized Payment Amount | 1773.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 88 |
| Number Of Medical Services | 3015 |
| Number Of Medicare Beneficiaries With Medical Services | 2206 |
| Total Medical Submitted Charge Amount | 1374498 |
| Total Medical Medicare Allowed Amount | 255160.79 |
| Total Medical Medicare Payment Amount | 192519.1 |
| Total Medical Medicare Standardized Payment Amount | 178275.45 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 180 |
| Number Of Beneficiaries Age 65 to 74 | 809 |
| Number Of Beneficiaries Age 75 to 84 | 761 |
| Number Of Beneficiaries Age Greater 84 | 456 |
| Number Of Female Beneficiaries | 1260 |
| Number Of Male Beneficiaries | 946 |
| Number Of Non Hispanic White Beneficiaries | 1597 |
| Number Of Black or African American Beneficiaries | 139 |
| Number Of AsianPacific Islander Beneficiaries | 301 |
| Number Of Hispanic Beneficiaries | 108 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1830 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 376 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 21 |
| Average HCC Risk Score Of Beneficiaries | 1.3795 |