| National Provider Identifier [NPI]: | 1912074402 |
| Last Name Of The Provider | LE |
| First Name Of The Provider | LINA |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1111 WEST LA PALMA AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ANAHEIM |
| Zip Code Of The Provider | 928012804 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 155 |
| Number Of Services | 3586 |
| Number Of Medicare Beneficiaries | 1754 |
| Total Submitted Charge Amount | 390149 |
| Total Medicare Allowed Amount | 97247.02 |
| Total Medicare Payment Amount | 76893.63 |
| Total Medicare Standardized Payment Amount | 71878.4 |
| 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 | 155 |
| Number Of Medical Services | 3586 |
| Number Of Medicare Beneficiaries With Medical Services | 1754 |
| Total Medical Submitted Charge Amount | 390149 |
| Total Medical Medicare Allowed Amount | 97247.02 |
| Total Medical Medicare Payment Amount | 76893.63 |
| Total Medical Medicare Standardized Payment Amount | 71878.4 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 267 |
| Number Of Beneficiaries Age 65 to 74 | 642 |
| Number Of Beneficiaries Age 75 to 84 | 542 |
| Number Of Beneficiaries Age Greater 84 | 303 |
| Number Of Female Beneficiaries | 1280 |
| Number Of Male Beneficiaries | 474 |
| Number Of Non Hispanic White Beneficiaries | 881 |
| Number Of Black or African American Beneficiaries | 55 |
| Number Of AsianPacific Islander Beneficiaries | 280 |
| Number Of Hispanic Beneficiaries | 485 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 879 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 875 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.0571 |