| National Provider Identifier [NPI]: | 1790724854 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | KWANG |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6980 SMOKE RANCH RD |
| Street Address 2 Of The Provider | STE 110 |
| City Of The Provider | LAS VEGAS |
| Zip Code Of The Provider | 891288605 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 9915 |
| Number Of Medicare Beneficiaries | 1326 |
| Total Submitted Charge Amount | 3575805 |
| Total Medicare Allowed Amount | 1805539.62 |
| Total Medicare Payment Amount | 1346315.02 |
| Total Medicare Standardized Payment Amount | 1345092.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 2707 |
| Number Of Medicare Beneficiaries With Drug Services | 216 |
| Total Drug Submitted ChargeAmount | 1584820 |
| Total Drug Medicare AllowedAmount | 1032619.68 |
| Total Drug Medicare PaymentAmount | 778894.01 |
| Total Drug Medicare Standardized Payment Amount | 778894.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 7208 |
| Number Of Medicare Beneficiaries With Medical Services | 1326 |
| Total Medical Submitted Charge Amount | 1990985 |
| Total Medical Medicare Allowed Amount | 772919.94 |
| Total Medical Medicare Payment Amount | 567421.01 |
| Total Medical Medicare Standardized Payment Amount | 566198.96 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 91 |
| Number Of Beneficiaries Age 65 to 74 | 567 |
| Number Of Beneficiaries Age 75 to 84 | 447 |
| Number Of Beneficiaries Age Greater 84 | 221 |
| Number Of Female Beneficiaries | 720 |
| Number Of Male Beneficiaries | 606 |
| Number Of Non Hispanic White Beneficiaries | 934 |
| Number Of Black or African American Beneficiaries | 96 |
| Number Of AsianPacific Islander Beneficiaries | 134 |
| Number Of Hispanic Beneficiaries | 119 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1128 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 198 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3911 |