| National Provider Identifier [NPI]: | 1629183884 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | TERRY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9100 W 74TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SHAWNEE MISSION |
| Zip Code Of The Provider | 662044004 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 254 |
| Number Of Services | 3919 |
| Number Of Medicare Beneficiaries | 1635 |
| Total Submitted Charge Amount | 708127.12 |
| Total Medicare Allowed Amount | 145196.79 |
| Total Medicare Payment Amount | 112213.72 |
| Total Medicare Standardized Payment Amount | 119012.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1055 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 2035 |
| Total Drug Medicare AllowedAmount | 501.3 |
| Total Drug Medicare PaymentAmount | 393 |
| Total Drug Medicare Standardized Payment Amount | 393 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 249 |
| Number Of Medical Services | 2864 |
| Number Of Medicare Beneficiaries With Medical Services | 1635 |
| Total Medical Submitted Charge Amount | 706092.12 |
| Total Medical Medicare Allowed Amount | 144695.49 |
| Total Medical Medicare Payment Amount | 111820.72 |
| Total Medical Medicare Standardized Payment Amount | 118619.5 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 237 |
| Number Of Beneficiaries Age 65 to 74 | 591 |
| Number Of Beneficiaries Age 75 to 84 | 469 |
| Number Of Beneficiaries Age Greater 84 | 338 |
| Number Of Female Beneficiaries | 933 |
| Number Of Male Beneficiaries | 702 |
| Number Of Non Hispanic White Beneficiaries | 1470 |
| Number Of Black or African American Beneficiaries | 89 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 43 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1414 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 221 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6924 |