| National Provider Identifier [NPI]: | 1104830371 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | JASON |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 227 W JANSS RD |
| Street Address 2 Of The Provider | #150 |
| City Of The Provider | THOUSAND OAKS |
| Zip Code Of The Provider | 913601848 |
| 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 | 252 |
| Number Of Services | 20574 |
| Number Of Medicare Beneficiaries | 2794 |
| Total Submitted Charge Amount | 1584768 |
| Total Medicare Allowed Amount | 473353.07 |
| Total Medicare Payment Amount | 365245.44 |
| Total Medicare Standardized Payment Amount | 345615.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 14861 |
| Number Of Medicare Beneficiaries With Drug Services | 166 |
| Total Drug Submitted ChargeAmount | 14927 |
| Total Drug Medicare AllowedAmount | 4103.05 |
| Total Drug Medicare PaymentAmount | 3067.91 |
| Total Drug Medicare Standardized Payment Amount | 3067.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 249 |
| Number Of Medical Services | 5713 |
| Number Of Medicare Beneficiaries With Medical Services | 2794 |
| Total Medical Submitted Charge Amount | 1569841 |
| Total Medical Medicare Allowed Amount | 469250.02 |
| Total Medical Medicare Payment Amount | 362177.53 |
| Total Medical Medicare Standardized Payment Amount | 342548.02 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 197 |
| Number Of Beneficiaries Age 65 to 74 | 986 |
| Number Of Beneficiaries Age 75 to 84 | 907 |
| Number Of Beneficiaries Age Greater 84 | 704 |
| Number Of Female Beneficiaries | 1561 |
| Number Of Male Beneficiaries | 1233 |
| Number Of Non Hispanic White Beneficiaries | 2446 |
| Number Of Black or African American Beneficiaries | 35 |
| Number Of AsianPacific Islander Beneficiaries | 102 |
| Number Of Hispanic Beneficiaries | 162 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 49 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2432 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 362 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7831 |