| National Provider Identifier [NPI]: | 1275532145 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | SIMON |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1828 EL CAMINO REAL |
| Street Address 2 Of The Provider | SUITE 406 |
| City Of The Provider | BURLINGAME |
| Zip Code Of The Provider | 940103103 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 5137 |
| Number Of Medicare Beneficiaries | 563 |
| Total Submitted Charge Amount | 576982 |
| Total Medicare Allowed Amount | 394561.41 |
| Total Medicare Payment Amount | 313574.63 |
| Total Medicare Standardized Payment Amount | 259311.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 540 |
| Number Of Medicare Beneficiaries With Drug Services | 287 |
| Total Drug Submitted ChargeAmount | 11712 |
| Total Drug Medicare AllowedAmount | 4843 |
| Total Drug Medicare PaymentAmount | 4630.28 |
| Total Drug Medicare Standardized Payment Amount | 4630.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 4597 |
| Number Of Medicare Beneficiaries With Medical Services | 563 |
| Total Medical Submitted Charge Amount | 565270 |
| Total Medical Medicare Allowed Amount | 389718.41 |
| Total Medical Medicare Payment Amount | 308944.35 |
| Total Medical Medicare Standardized Payment Amount | 254681.59 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 250 |
| Number Of Beneficiaries Age 75 to 84 | 201 |
| Number Of Beneficiaries Age Greater 84 | 95 |
| Number Of Female Beneficiaries | 345 |
| Number Of Male Beneficiaries | 218 |
| Number Of Non Hispanic White Beneficiaries | 13 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 529 |
| 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 | 147 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 416 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 7 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 1.0087 |