| National Provider Identifier [NPI]: | 1679559538 |
| Last Name Of The Provider | JEE |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2121 N 1700 W |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAYTON |
| Zip Code Of The Provider | 840418803 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 1598 |
| Number Of Medicare Beneficiaries | 128 |
| Total Submitted Charge Amount | 135077 |
| Total Medicare Allowed Amount | 61214.58 |
| Total Medicare Payment Amount | 45330.29 |
| Total Medicare Standardized Payment Amount | 49352.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 896 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 15094 |
| Total Drug Medicare AllowedAmount | 10809.07 |
| Total Drug Medicare PaymentAmount | 8447.17 |
| Total Drug Medicare Standardized Payment Amount | 8447.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 65 |
| Number Of Medical Services | 702 |
| Number Of Medicare Beneficiaries With Medical Services | 128 |
| Total Medical Submitted Charge Amount | 119983 |
| Total Medical Medicare Allowed Amount | 50405.51 |
| Total Medical Medicare Payment Amount | 36883.12 |
| Total Medical Medicare Standardized Payment Amount | 40904.92 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 51 |
| Number Of Beneficiaries Age 75 to 84 | 39 |
| Number Of Beneficiaries Age Greater 84 | 22 |
| Number Of Female Beneficiaries | 79 |
| Number Of Male Beneficiaries | 49 |
| Number Of Non Hispanic White Beneficiaries | 107 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 114 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 14 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 69 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2187 |