| National Provider Identifier [NPI]: | 1457372963 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | JASON |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 833 CHESTNUT ST |
| Street Address 2 Of The Provider | SUITE 740 |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191074414 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 75 |
| Number Of Services | 7875 |
| Number Of Medicare Beneficiaries | 3865 |
| Total Submitted Charge Amount | 1181665 |
| Total Medicare Allowed Amount | 575942.11 |
| Total Medicare Payment Amount | 439557.43 |
| Total Medicare Standardized Payment Amount | 330733 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 18 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 3460 |
| Total Drug Medicare AllowedAmount | 2732.22 |
| Total Drug Medicare PaymentAmount | 2142.01 |
| Total Drug Medicare Standardized Payment Amount | 2142.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 73 |
| Number Of Medical Services | 7857 |
| Number Of Medicare Beneficiaries With Medical Services | 3865 |
| Total Medical Submitted Charge Amount | 1178205 |
| Total Medical Medicare Allowed Amount | 573209.89 |
| Total Medical Medicare Payment Amount | 437415.42 |
| Total Medical Medicare Standardized Payment Amount | 328590.99 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 204 |
| Number Of Beneficiaries Age 65 to 74 | 1831 |
| Number Of Beneficiaries Age 75 to 84 | 1262 |
| Number Of Beneficiaries Age Greater 84 | 568 |
| Number Of Female Beneficiaries | 1952 |
| Number Of Male Beneficiaries | 1913 |
| Number Of Non Hispanic White Beneficiaries | 3602 |
| Number Of Black or African American Beneficiaries | 105 |
| Number Of AsianPacific Islander Beneficiaries | 51 |
| Number Of Hispanic Beneficiaries | 52 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 55 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3658 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 207 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0586 |