| National Provider Identifier [NPI]: | 1558375402 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | SARHA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2875 S 171ST ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW BERLIN |
| Zip Code Of The Provider | 531513511 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 140 |
| Number Of Services | 3914 |
| Number Of Medicare Beneficiaries | 2328 |
| Total Submitted Charge Amount | 941831 |
| Total Medicare Allowed Amount | 130489.93 |
| Total Medicare Payment Amount | 109171.97 |
| Total Medicare Standardized Payment Amount | 116127.84 |
| 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 | 140 |
| Number Of Medical Services | 3914 |
| Number Of Medicare Beneficiaries With Medical Services | 2328 |
| Total Medical Submitted Charge Amount | 941831 |
| Total Medical Medicare Allowed Amount | 130489.93 |
| Total Medical Medicare Payment Amount | 109171.97 |
| Total Medical Medicare Standardized Payment Amount | 116127.84 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 478 |
| Number Of Beneficiaries Age 65 to 74 | 930 |
| Number Of Beneficiaries Age 75 to 84 | 629 |
| Number Of Beneficiaries Age Greater 84 | 291 |
| Number Of Female Beneficiaries | 1877 |
| Number Of Male Beneficiaries | 451 |
| Number Of Non Hispanic White Beneficiaries | 1773 |
| Number Of Black or African American Beneficiaries | 395 |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| Number Of Hispanic Beneficiaries | 104 |
| Number Of American Indian Alaska Native Beneficiaries | 11 |
| Number Of Beneficiaries With Race Not Else where Classified | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1632 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 696 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.6064 |