| National Provider Identifier [NPI]: | 1629098348 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | LAWRENCE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 601 EAST 14TH STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | SEDALIA |
| Zip Code Of The Provider | 653021706 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 164 |
| Number Of Services | 6420 |
| Number Of Medicare Beneficiaries | 2659 |
| Total Submitted Charge Amount | 681826.97 |
| Total Medicare Allowed Amount | 184717.44 |
| Total Medicare Payment Amount | 139954.97 |
| Total Medicare Standardized Payment Amount | 148280.94 |
| 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 | 164 |
| Number Of Medical Services | 6420 |
| Number Of Medicare Beneficiaries With Medical Services | 2659 |
| Total Medical Submitted Charge Amount | 681826.97 |
| Total Medical Medicare Allowed Amount | 184717.44 |
| Total Medical Medicare Payment Amount | 139954.97 |
| Total Medical Medicare Standardized Payment Amount | 148280.94 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 554 |
| Number Of Beneficiaries Age 65 to 74 | 903 |
| Number Of Beneficiaries Age 75 to 84 | 796 |
| Number Of Beneficiaries Age Greater 84 | 406 |
| Number Of Female Beneficiaries | 1698 |
| Number Of Male Beneficiaries | 961 |
| Number Of Non Hispanic White Beneficiaries | 2543 |
| Number Of Black or African American Beneficiaries | 68 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2011 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 648 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.3923 |