| National Provider Identifier [NPI]: | 1750540613 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | KEAGAN |
| 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 | 11820 PARKLAWN DR |
| Street Address 2 Of The Provider | SUITE 402 |
| City Of The Provider | ROCKVILLE |
| Zip Code Of The Provider | 208522529 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 9 |
| Number Of Services | 4556 |
| Number Of Medicare Beneficiaries | 2261 |
| Total Submitted Charge Amount | 1074348 |
| Total Medicare Allowed Amount | 317028.91 |
| Total Medicare Payment Amount | 241949.46 |
| Total Medicare Standardized Payment Amount | 182719.1 |
| 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 | 9 |
| Number Of Medical Services | 4556 |
| Number Of Medicare Beneficiaries With Medical Services | 2261 |
| Total Medical Submitted Charge Amount | 1074348 |
| Total Medical Medicare Allowed Amount | 317028.91 |
| Total Medical Medicare Payment Amount | 241949.46 |
| Total Medical Medicare Standardized Payment Amount | 182719.1 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 53 |
| Number Of Beneficiaries Age 65 to 74 | 1059 |
| Number Of Beneficiaries Age 75 to 84 | 758 |
| Number Of Beneficiaries Age Greater 84 | 391 |
| Number Of Female Beneficiaries | 1053 |
| Number Of Male Beneficiaries | 1208 |
| Number Of Non Hispanic White Beneficiaries | 2084 |
| Number Of Black or African American Beneficiaries | 46 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 96 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2202 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 59 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0104 |