| National Provider Identifier [NPI]: | 1447379375 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | MAXIMILIAN |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 85 SEYMOUR ST |
| Street Address 2 Of The Provider | SUITE 719 |
| City Of The Provider | HARTFORD |
| Zip Code Of The Provider | 061065501 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 6008 |
| Number Of Medicare Beneficiaries | 1946 |
| Total Submitted Charge Amount | 823205.87 |
| Total Medicare Allowed Amount | 337289.94 |
| Total Medicare Payment Amount | 254357.84 |
| Total Medicare Standardized Payment Amount | 237202.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2215 |
| Number Of Medicare Beneficiaries With Drug Services | 71 |
| Total Drug Submitted ChargeAmount | 24937.86 |
| Total Drug Medicare AllowedAmount | 15258.11 |
| Total Drug Medicare PaymentAmount | 11784.69 |
| Total Drug Medicare Standardized Payment Amount | 11784.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 3793 |
| Number Of Medicare Beneficiaries With Medical Services | 1946 |
| Total Medical Submitted Charge Amount | 798268.01 |
| Total Medical Medicare Allowed Amount | 322031.83 |
| Total Medical Medicare Payment Amount | 242573.15 |
| Total Medical Medicare Standardized Payment Amount | 225417.52 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 318 |
| Number Of Beneficiaries Age 65 to 74 | 610 |
| Number Of Beneficiaries Age 75 to 84 | 606 |
| Number Of Beneficiaries Age Greater 84 | 412 |
| Number Of Female Beneficiaries | 928 |
| Number Of Male Beneficiaries | 1018 |
| Number Of Non Hispanic White Beneficiaries | 1562 |
| Number Of Black or African American Beneficiaries | 152 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 167 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1302 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 644 |
| Percent Of With Atrial Fibrillation | 32 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.1092 |