| National Provider Identifier [NPI]: | 1528223765 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 44 E JIMMIE LEEDS RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | GALLOWAY |
| Zip Code Of The Provider | 082059599 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 6733 |
| Number Of Medicare Beneficiaries | 2906 |
| Total Submitted Charge Amount | 1537983 |
| Total Medicare Allowed Amount | 514149.71 |
| Total Medicare Payment Amount | 471222.4 |
| Total Medicare Standardized Payment Amount | 429902.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 619 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 2476 |
| Total Drug Medicare AllowedAmount | 1232.07 |
| Total Drug Medicare PaymentAmount | 965.96 |
| Total Drug Medicare Standardized Payment Amount | 965.96 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 6114 |
| Number Of Medicare Beneficiaries With Medical Services | 2906 |
| Total Medical Submitted Charge Amount | 1535507 |
| Total Medical Medicare Allowed Amount | 512917.64 |
| Total Medical Medicare Payment Amount | 470256.44 |
| Total Medical Medicare Standardized Payment Amount | 428936.6 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 275 |
| Number Of Beneficiaries Age 65 to 74 | 1636 |
| Number Of Beneficiaries Age 75 to 84 | 836 |
| Number Of Beneficiaries Age Greater 84 | 159 |
| Number Of Female Beneficiaries | 2875 |
| Number Of Male Beneficiaries | 31 |
| Number Of Non Hispanic White Beneficiaries | 2458 |
| Number Of Black or African American Beneficiaries | 254 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 126 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 39 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2688 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 218 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8743 |