| National Provider Identifier [NPI]: | 1033308010 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | KELLY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | FNP-RX AUTH |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 711 EAST LAMAR BLVD |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | ARLINGTON |
| Zip Code Of The Provider | 760113888 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 1627 |
| Number Of Medicare Beneficiaries | 301 |
| Total Submitted Charge Amount | 89350.92 |
| Total Medicare Allowed Amount | 67054.72 |
| Total Medicare Payment Amount | 48409.57 |
| Total Medicare Standardized Payment Amount | 60363.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 22 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 66 |
| Total Drug Medicare AllowedAmount | 39.23 |
| Total Drug Medicare PaymentAmount | 30.73 |
| Total Drug Medicare Standardized Payment Amount | 30.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 1605 |
| Number Of Medicare Beneficiaries With Medical Services | 301 |
| Total Medical Submitted Charge Amount | 89284.92 |
| Total Medical Medicare Allowed Amount | 67015.49 |
| Total Medical Medicare Payment Amount | 48378.84 |
| Total Medical Medicare Standardized Payment Amount | 60332.77 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 163 |
| Number Of Beneficiaries Age 75 to 84 | 84 |
| Number Of Beneficiaries Age Greater 84 | 30 |
| Number Of Female Beneficiaries | 162 |
| Number Of Male Beneficiaries | 139 |
| 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 | 262 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 39 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0124 |