| National Provider Identifier [NPI]: | 1255442760 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | ANDREW |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3000 Q ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SACRAMENTO |
| Zip Code Of The Provider | 958167058 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 117 |
| Number Of Services | 9128 |
| Number Of Medicare Beneficiaries | 4353 |
| Total Submitted Charge Amount | 1072854.7 |
| Total Medicare Allowed Amount | 271223.87 |
| Total Medicare Payment Amount | 210999.01 |
| Total Medicare Standardized Payment Amount | 203744.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 2803 |
| Number Of Medicare Beneficiaries With Drug Services | 44 |
| Total Drug Submitted ChargeAmount | 4980.5 |
| Total Drug Medicare AllowedAmount | 706.36 |
| Total Drug Medicare PaymentAmount | 553.74 |
| Total Drug Medicare Standardized Payment Amount | 553.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 113 |
| Number Of Medical Services | 6325 |
| Number Of Medicare Beneficiaries With Medical Services | 4353 |
| Total Medical Submitted Charge Amount | 1067874.2 |
| Total Medical Medicare Allowed Amount | 270517.51 |
| Total Medical Medicare Payment Amount | 210445.27 |
| Total Medical Medicare Standardized Payment Amount | 203190.68 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 942 |
| Number Of Beneficiaries Age 65 to 74 | 1599 |
| Number Of Beneficiaries Age 75 to 84 | 1194 |
| Number Of Beneficiaries Age Greater 84 | 618 |
| Number Of Female Beneficiaries | 2661 |
| Number Of Male Beneficiaries | 1692 |
| Number Of Non Hispanic White Beneficiaries | 2997 |
| Number Of Black or African American Beneficiaries | 428 |
| Number Of AsianPacific Islander Beneficiaries | 422 |
| Number Of Hispanic Beneficiaries | 397 |
| Number Of American Indian Alaska Native Beneficiaries | 24 |
| Number Of Beneficiaries With Race Not Else where Classified | 85 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2630 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1723 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6247 |