| National Provider Identifier [NPI]: | 1194772418 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | SAMUEL |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 18400 US HIGHWAY 18 |
| Street Address 2 Of The Provider | |
| City Of The Provider | APPLE VALLEY |
| Zip Code Of The Provider | 923072306 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 105 |
| Number Of Services | 2968 |
| Number Of Medicare Beneficiaries | 817 |
| Total Submitted Charge Amount | 1650438 |
| Total Medicare Allowed Amount | 528762.56 |
| Total Medicare Payment Amount | 402380.06 |
| Total Medicare Standardized Payment Amount | 388433.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 178 |
| Number Of Medicare Beneficiaries With Drug Services | 47 |
| Total Drug Submitted ChargeAmount | 209186 |
| Total Drug Medicare AllowedAmount | 97289.89 |
| Total Drug Medicare PaymentAmount | 76022.31 |
| Total Drug Medicare Standardized Payment Amount | 76022.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 99 |
| Number Of Medical Services | 2790 |
| Number Of Medicare Beneficiaries With Medical Services | 817 |
| Total Medical Submitted Charge Amount | 1441252 |
| Total Medical Medicare Allowed Amount | 431472.67 |
| Total Medical Medicare Payment Amount | 326357.75 |
| Total Medical Medicare Standardized Payment Amount | 312411.5 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 142 |
| Number Of Beneficiaries Age 65 to 74 | 303 |
| Number Of Beneficiaries Age 75 to 84 | 274 |
| Number Of Beneficiaries Age Greater 84 | 98 |
| Number Of Female Beneficiaries | 243 |
| Number Of Male Beneficiaries | 574 |
| Number Of Non Hispanic White Beneficiaries | 479 |
| Number Of Black or African American Beneficiaries | 76 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 229 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 452 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 365 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.6605 |