| National Provider Identifier [NPI]: | 1114918588 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | JAE |
| Middle Initial Of The Provider | Y |
| Credentials Of The Provider | DO LLC |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 14100 E ARAPAHOE RD |
| Street Address 2 Of The Provider | SUITE 360 |
| City Of The Provider | CENTENNIAL |
| Zip Code Of The Provider | 801124028 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 5227 |
| Number Of Medicare Beneficiaries | 500 |
| Total Submitted Charge Amount | 298844.63 |
| Total Medicare Allowed Amount | 226584.92 |
| Total Medicare Payment Amount | 158148.99 |
| Total Medicare Standardized Payment Amount | 157508.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 2403 |
| Number Of Medicare Beneficiaries With Drug Services | 193 |
| Total Drug Submitted ChargeAmount | 57770 |
| Total Drug Medicare AllowedAmount | 35259.12 |
| Total Drug Medicare PaymentAmount | 28510.37 |
| Total Drug Medicare Standardized Payment Amount | 28510.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 2824 |
| Number Of Medicare Beneficiaries With Medical Services | 500 |
| Total Medical Submitted Charge Amount | 241074.63 |
| Total Medical Medicare Allowed Amount | 191325.8 |
| Total Medical Medicare Payment Amount | 129638.62 |
| Total Medical Medicare Standardized Payment Amount | 128997.77 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 258 |
| Number Of Beneficiaries Age 75 to 84 | 146 |
| Number Of Beneficiaries Age Greater 84 | 45 |
| Number Of Female Beneficiaries | 286 |
| Number Of Male Beneficiaries | 214 |
| Number Of Non Hispanic White Beneficiaries | 152 |
| Number Of Black or African American Beneficiaries | 21 |
| Number Of AsianPacific Islander Beneficiaries | 298 |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 251 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 249 |
| Percent Of With Atrial Fibrillation | 3 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 4 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 4 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 13 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.8401 |