| National Provider Identifier [NPI]: | 1669429908 |
| Last Name Of The Provider | BEE |
| First Name Of The Provider | LEE |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | D.O., F.A.C.O.I. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 107 W FRANKLIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SESSER |
| Zip Code Of The Provider | 628841456 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 121 |
| Number Of Services | 3150 |
| Number Of Medicare Beneficiaries | 47 |
| Total Submitted Charge Amount | 411530.83 |
| Total Medicare Allowed Amount | 120713.31 |
| Total Medicare Payment Amount | 93310.73 |
| Total Medicare Standardized Payment Amount | 91928.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 22 |
| Number Of Drug Services | 1223 |
| Number Of Medicare Beneficiaries With Drug Services | 44 |
| Total Drug Submitted ChargeAmount | 20864.65 |
| Total Drug Medicare AllowedAmount | 2877.19 |
| Total Drug Medicare PaymentAmount | 2565.11 |
| Total Drug Medicare Standardized Payment Amount | 2565.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 99 |
| Number Of Medical Services | 1927 |
| Number Of Medicare Beneficiaries With Medical Services | 47 |
| Total Medical Submitted Charge Amount | 390666.18 |
| Total Medical Medicare Allowed Amount | 117836.12 |
| Total Medical Medicare Payment Amount | 90745.62 |
| Total Medical Medicare Standardized Payment Amount | 89362.91 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 20 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 23 |
| Number Of Male Beneficiaries | 24 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 31 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 30 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 70 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 55 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 28 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 64 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.5919 |