| National Provider Identifier [NPI]: | 1861441552 |
| Last Name Of The Provider | LE |
| First Name Of The Provider | SON |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8887 WESTMINSTER AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GARDEN GROVE |
| Zip Code Of The Provider | 928442608 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 5411 |
| Number Of Medicare Beneficiaries | 245 |
| Total Submitted Charge Amount | 285918.89 |
| Total Medicare Allowed Amount | 214010.84 |
| Total Medicare Payment Amount | 160558.61 |
| Total Medicare Standardized Payment Amount | 152906.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 100 |
| Number Of Medicare Beneficiaries With Drug Services | 91 |
| Total Drug Submitted ChargeAmount | 1419.99 |
| Total Drug Medicare AllowedAmount | 1227.49 |
| Total Drug Medicare PaymentAmount | 1201.36 |
| Total Drug Medicare Standardized Payment Amount | 1201.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 5311 |
| Number Of Medicare Beneficiaries With Medical Services | 245 |
| Total Medical Submitted Charge Amount | 284498.9 |
| Total Medical Medicare Allowed Amount | 212783.35 |
| Total Medical Medicare Payment Amount | 159357.25 |
| Total Medical Medicare Standardized Payment Amount | 151705.04 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 118 |
| Number Of Beneficiaries Age 75 to 84 | 76 |
| Number Of Beneficiaries Age Greater 84 | 34 |
| Number Of Female Beneficiaries | 134 |
| Number Of Male Beneficiaries | 111 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | 233 |
| 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 | 20 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 225 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 25 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2261 |