| National Provider Identifier [NPI]: | 1639498462 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | VINCENT |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4000 LINWOOD DR |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | PARAGOULD |
| Zip Code Of The Provider | 724507223 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 652 |
| Number Of Medicare Beneficiaries | 169 |
| Total Submitted Charge Amount | 86467 |
| Total Medicare Allowed Amount | 44553.9 |
| Total Medicare Payment Amount | 34364.61 |
| Total Medicare Standardized Payment Amount | 38005.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 44 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 359 |
| Total Drug Medicare AllowedAmount | 201.48 |
| Total Drug Medicare PaymentAmount | 193.51 |
| Total Drug Medicare Standardized Payment Amount | 193.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 608 |
| Number Of Medicare Beneficiaries With Medical Services | 165 |
| Total Medical Submitted Charge Amount | 86108 |
| Total Medical Medicare Allowed Amount | 44352.42 |
| Total Medical Medicare Payment Amount | 34171.1 |
| Total Medical Medicare Standardized Payment Amount | 37812.19 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 55 |
| Number Of Beneficiaries Age 65 to 74 | 60 |
| Number Of Beneficiaries Age 75 to 84 | 41 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 100 |
| Number Of Male Beneficiaries | 69 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 96 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 73 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6689 |