| National Provider Identifier [NPI]: | 1942216296 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | NANCY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12221 N. MOPAC EXPRESSWAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | AUSTIN |
| Zip Code Of The Provider | 787582483 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 311 |
| Number Of Medicare Beneficiaries | 112 |
| Total Submitted Charge Amount | 20414.69 |
| Total Medicare Allowed Amount | 17301.29 |
| Total Medicare Payment Amount | 13165.32 |
| Total Medicare Standardized Payment Amount | 15935.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 33 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 181.57 |
| Total Drug Medicare AllowedAmount | 181.57 |
| Total Drug Medicare PaymentAmount | 168.81 |
| Total Drug Medicare Standardized Payment Amount | 168.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 278 |
| Number Of Medicare Beneficiaries With Medical Services | 112 |
| Total Medical Submitted Charge Amount | 20233.12 |
| Total Medical Medicare Allowed Amount | 17119.72 |
| Total Medical Medicare Payment Amount | 12996.51 |
| Total Medical Medicare Standardized Payment Amount | 15766.47 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 32 |
| Number Of Beneficiaries Age 65 to 74 | 44 |
| Number Of Beneficiaries Age 75 to 84 | 23 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 76 |
| Number Of Male Beneficiaries | 36 |
| Number Of Non Hispanic White Beneficiaries | 86 |
| Number Of Black or African American Beneficiaries | 13 |
| 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 | 85 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 27 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 27 |
| Average HCC Risk Score Of Beneficiaries | 1.9441 |