| National Provider Identifier [NPI]: | 1265684864 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | JULIE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 28 CRESCENT ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MIDDLETOWN |
| Zip Code Of The Provider | 064573654 |
| 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 | 179 |
| Number Of Services | 4495 |
| Number Of Medicare Beneficiaries | 2528 |
| Total Submitted Charge Amount | 494284.93 |
| Total Medicare Allowed Amount | 156842.65 |
| Total Medicare Payment Amount | 123822.3 |
| Total Medicare Standardized Payment Amount | 117581.24 |
| 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 | 179 |
| Number Of Medical Services | 4495 |
| Number Of Medicare Beneficiaries With Medical Services | 2528 |
| Total Medical Submitted Charge Amount | 494284.93 |
| Total Medical Medicare Allowed Amount | 156842.65 |
| Total Medical Medicare Payment Amount | 123822.3 |
| Total Medical Medicare Standardized Payment Amount | 117581.24 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 325 |
| Number Of Beneficiaries Age 65 to 74 | 946 |
| Number Of Beneficiaries Age 75 to 84 | 792 |
| Number Of Beneficiaries Age Greater 84 | 465 |
| Number Of Female Beneficiaries | 1800 |
| Number Of Male Beneficiaries | 728 |
| Number Of Non Hispanic White Beneficiaries | 2317 |
| Number Of Black or African American Beneficiaries | 98 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 54 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 44 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1826 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 702 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4445 |