| National Provider Identifier [NPI]: | 1629244918 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | EDWIN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1510 S CENTRAL AVE |
| Street Address 2 Of The Provider | SUITE 150 |
| City Of The Provider | GLENDALE |
| Zip Code Of The Provider | 912042500 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 4933 |
| Number Of Medicare Beneficiaries | 1212 |
| Total Submitted Charge Amount | 1457435 |
| Total Medicare Allowed Amount | 778212.39 |
| Total Medicare Payment Amount | 594478.54 |
| Total Medicare Standardized Payment Amount | 539530.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 312 |
| Number Of Medicare Beneficiaries With Drug Services | 78 |
| Total Drug Submitted ChargeAmount | 50310 |
| Total Drug Medicare AllowedAmount | 16485.3 |
| Total Drug Medicare PaymentAmount | 12808.92 |
| Total Drug Medicare Standardized Payment Amount | 12808.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 4621 |
| Number Of Medicare Beneficiaries With Medical Services | 1212 |
| Total Medical Submitted Charge Amount | 1407125 |
| Total Medical Medicare Allowed Amount | 761727.09 |
| Total Medical Medicare Payment Amount | 581669.62 |
| Total Medical Medicare Standardized Payment Amount | 526721.62 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 119 |
| Number Of Beneficiaries Age 65 to 74 | 436 |
| Number Of Beneficiaries Age 75 to 84 | 413 |
| Number Of Beneficiaries Age Greater 84 | 244 |
| Number Of Female Beneficiaries | 658 |
| Number Of Male Beneficiaries | 554 |
| Number Of Non Hispanic White Beneficiaries | 650 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 175 |
| Number Of Hispanic Beneficiaries | 251 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 76 |
| Number Of Beneficiaries With Medicare Only Entitlement | 176 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1036 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 30 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 51 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 60 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.1356 |