| National Provider Identifier [NPI]: | 1245273457 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | VICTOR |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 101 E. VALENCIA MESA DR. |
| Street Address 2 Of The Provider | |
| City Of The Provider | FULLERTON |
| Zip Code Of The Provider | 92631 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 266 |
| Number Of Services | 133354 |
| Number Of Medicare Beneficiaries | 12324 |
| Total Submitted Charge Amount | 4827689 |
| Total Medicare Allowed Amount | 1738639.51 |
| Total Medicare Payment Amount | 1690312.79 |
| Total Medicare Standardized Payment Amount | 1688213.57 |
| 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 | 266 |
| Number Of Medical Services | 133354 |
| Number Of Medicare Beneficiaries With Medical Services | 12324 |
| Total Medical Submitted Charge Amount | 4827689 |
| Total Medical Medicare Allowed Amount | 1738639.51 |
| Total Medical Medicare Payment Amount | 1690312.79 |
| Total Medical Medicare Standardized Payment Amount | 1688213.57 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 681 |
| Number Of Beneficiaries Age 65 to 74 | 5368 |
| Number Of Beneficiaries Age 75 to 84 | 4105 |
| Number Of Beneficiaries Age Greater 84 | 2170 |
| Number Of Female Beneficiaries | 7255 |
| Number Of Male Beneficiaries | 5069 |
| Number Of Non Hispanic White Beneficiaries | 9532 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 1067 |
| Number Of Hispanic Beneficiaries | 1239 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 299 |
| Number Of Beneficiaries With Medicare Only Entitlement | 11027 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1297 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1126 |