| National Provider Identifier [NPI]: | 1396765467 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | MOO |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9115 S TACOMA WAY STE 105 |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAKEWOOD |
| Zip Code Of The Provider | 984994400 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 2327 |
| Number Of Medicare Beneficiaries | 321 |
| Total Submitted Charge Amount | 175204 |
| Total Medicare Allowed Amount | 118650.94 |
| Total Medicare Payment Amount | 76014.72 |
| Total Medicare Standardized Payment Amount | 76968.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 222 |
| Number Of Medicare Beneficiaries With Drug Services | 189 |
| Total Drug Submitted ChargeAmount | 8916 |
| Total Drug Medicare AllowedAmount | 5564.87 |
| Total Drug Medicare PaymentAmount | 5441.9 |
| Total Drug Medicare Standardized Payment Amount | 5441.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 2105 |
| Number Of Medicare Beneficiaries With Medical Services | 321 |
| Total Medical Submitted Charge Amount | 166288 |
| Total Medical Medicare Allowed Amount | 113086.07 |
| Total Medical Medicare Payment Amount | 70572.82 |
| Total Medical Medicare Standardized Payment Amount | 71527 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 18 |
| Number Of Beneficiaries Age 65 to 74 | 166 |
| Number Of Beneficiaries Age 75 to 84 | 103 |
| Number Of Beneficiaries Age Greater 84 | 34 |
| Number Of Female Beneficiaries | 219 |
| Number Of Male Beneficiaries | 102 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 230 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 56 |
| Number Of Beneficiaries With Medicare Only Entitlement | 141 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 180 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 4 |
| Percent Of With Depression | 8 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 10 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8572 |