| National Provider Identifier [NPI]: | 1194775072 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | SHAWN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | D.C. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 505 SHATTO PL |
| Street Address 2 Of The Provider | # 203 |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900201754 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Chiropractic |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 3 |
| Number Of Services | 4024 |
| Number Of Medicare Beneficiaries | 367 |
| Total Submitted Charge Amount | 245295 |
| Total Medicare Allowed Amount | 197923.86 |
| Total Medicare Payment Amount | 155139.1 |
| Total Medicare Standardized Payment Amount | 152564.18 |
| 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 | 3 |
| Number Of Medical Services | 4024 |
| Number Of Medicare Beneficiaries With Medical Services | 367 |
| Total Medical Submitted Charge Amount | 245295 |
| Total Medical Medicare Allowed Amount | 197923.86 |
| Total Medical Medicare Payment Amount | 155139.1 |
| Total Medical Medicare Standardized Payment Amount | 152564.18 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 135 |
| Number Of Beneficiaries Age 75 to 84 | 167 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 266 |
| Number Of Male Beneficiaries | 101 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | 353 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 13 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 354 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 3 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 71 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 29 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3082 |