| National Provider Identifier [NPI]: | 1053335430 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | JASON |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6015 POINTE WEST BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BRADENTON |
| Zip Code Of The Provider | 342095532 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 79 |
| Number Of Services | 4022 |
| Number Of Medicare Beneficiaries | 444 |
| Total Submitted Charge Amount | 346343.22 |
| Total Medicare Allowed Amount | 97764.92 |
| Total Medicare Payment Amount | 75218.27 |
| Total Medicare Standardized Payment Amount | 82484.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 2534 |
| Number Of Medicare Beneficiaries With Drug Services | 134 |
| Total Drug Submitted ChargeAmount | 90739.2 |
| Total Drug Medicare AllowedAmount | 30368.12 |
| Total Drug Medicare PaymentAmount | 23737.57 |
| Total Drug Medicare Standardized Payment Amount | 23737.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 73 |
| Number Of Medical Services | 1488 |
| Number Of Medicare Beneficiaries With Medical Services | 444 |
| Total Medical Submitted Charge Amount | 255604.02 |
| Total Medical Medicare Allowed Amount | 67396.8 |
| Total Medical Medicare Payment Amount | 51480.7 |
| Total Medical Medicare Standardized Payment Amount | 58747.05 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 222 |
| Number Of Beneficiaries Age 75 to 84 | 142 |
| Number Of Beneficiaries Age Greater 84 | 53 |
| Number Of Female Beneficiaries | 273 |
| Number Of Male Beneficiaries | 171 |
| Number Of Non Hispanic White Beneficiaries | 415 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 407 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 37 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 1.1609 |