| National Provider Identifier [NPI]: | 1225184906 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | JENNY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3670 PARKER BLVD |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | PUEBLO |
| Zip Code Of The Provider | 810082285 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 64 |
| Number Of Services | 2256 |
| Number Of Medicare Beneficiaries | 1005 |
| Total Submitted Charge Amount | 661596.4 |
| Total Medicare Allowed Amount | 189476.41 |
| Total Medicare Payment Amount | 140257.55 |
| Total Medicare Standardized Payment Amount | 141094.19 |
| 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 | 64 |
| Number Of Medical Services | 2256 |
| Number Of Medicare Beneficiaries With Medical Services | 1005 |
| Total Medical Submitted Charge Amount | 661596.4 |
| Total Medical Medicare Allowed Amount | 189476.41 |
| Total Medical Medicare Payment Amount | 140257.55 |
| Total Medical Medicare Standardized Payment Amount | 141094.19 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 147 |
| Number Of Beneficiaries Age 65 to 74 | 371 |
| Number Of Beneficiaries Age 75 to 84 | 328 |
| Number Of Beneficiaries Age Greater 84 | 159 |
| Number Of Female Beneficiaries | 543 |
| Number Of Male Beneficiaries | 462 |
| Number Of Non Hispanic White Beneficiaries | 762 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 221 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 752 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 253 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5963 |