| National Provider Identifier [NPI]: | 1104034107 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | NELLIE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 190 EUCLID AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | RIDGEFIELD PARK |
| Zip Code Of The Provider | 076601742 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 3716 |
| Number Of Medicare Beneficiaries | 613 |
| Total Submitted Charge Amount | 275382.18 |
| Total Medicare Allowed Amount | 263714.2 |
| Total Medicare Payment Amount | 194569.04 |
| Total Medicare Standardized Payment Amount | 172664 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 197 |
| Number Of Medicare Beneficiaries With Drug Services | 158 |
| Total Drug Submitted ChargeAmount | 3580.25 |
| Total Drug Medicare AllowedAmount | 3473.06 |
| Total Drug Medicare PaymentAmount | 3393.52 |
| Total Drug Medicare Standardized Payment Amount | 3393.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 3519 |
| Number Of Medicare Beneficiaries With Medical Services | 613 |
| Total Medical Submitted Charge Amount | 271801.93 |
| Total Medical Medicare Allowed Amount | 260241.14 |
| Total Medical Medicare Payment Amount | 191175.52 |
| Total Medical Medicare Standardized Payment Amount | 169270.48 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 49 |
| Number Of Beneficiaries Age 65 to 74 | 199 |
| Number Of Beneficiaries Age 75 to 84 | 204 |
| Number Of Beneficiaries Age Greater 84 | 161 |
| Number Of Female Beneficiaries | 374 |
| Number Of Male Beneficiaries | 239 |
| Number Of Non Hispanic White Beneficiaries | 371 |
| Number Of Black or African American Beneficiaries | 52 |
| Number Of AsianPacific Islander Beneficiaries | 86 |
| Number Of Hispanic Beneficiaries | 80 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 484 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 129 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.9764 |