| National Provider Identifier [NPI]: | 1699709758 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | STEVE |
| Middle Initial Of The Provider | Y |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 111 FOUNDERS PLZ |
| Street Address 2 Of The Provider | STE. 400 |
| City Of The Provider | EAST HARTFORD |
| Zip Code Of The Provider | 061083212 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 178 |
| Number Of Services | 12094 |
| Number Of Medicare Beneficiaries | 3935 |
| Total Submitted Charge Amount | 1028040 |
| Total Medicare Allowed Amount | 266887.64 |
| Total Medicare Payment Amount | 215920.17 |
| Total Medicare Standardized Payment Amount | 204109.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 5364 |
| Number Of Medicare Beneficiaries With Drug Services | 62 |
| Total Drug Submitted ChargeAmount | 16882 |
| Total Drug Medicare AllowedAmount | 1162.52 |
| Total Drug Medicare PaymentAmount | 911.41 |
| Total Drug Medicare Standardized Payment Amount | 911.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 175 |
| Number Of Medical Services | 6730 |
| Number Of Medicare Beneficiaries With Medical Services | 3935 |
| Total Medical Submitted Charge Amount | 1011158 |
| Total Medical Medicare Allowed Amount | 265725.12 |
| Total Medical Medicare Payment Amount | 215008.76 |
| Total Medical Medicare Standardized Payment Amount | 203197.85 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 656 |
| Number Of Beneficiaries Age 65 to 74 | 1457 |
| Number Of Beneficiaries Age 75 to 84 | 1105 |
| Number Of Beneficiaries Age Greater 84 | 717 |
| Number Of Female Beneficiaries | 2637 |
| Number Of Male Beneficiaries | 1298 |
| Number Of Non Hispanic White Beneficiaries | 3303 |
| Number Of Black or African American Beneficiaries | 176 |
| Number Of AsianPacific Islander Beneficiaries | 43 |
| Number Of Hispanic Beneficiaries | 348 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 65 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2609 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1326 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.558 |