| National Provider Identifier [NPI]: | 1003802182 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | SANG |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7900 NW 23RD ST |
| Street Address 2 Of The Provider | SUITE 1 |
| City Of The Provider | BETHANY |
| Zip Code Of The Provider | 730084961 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 2159 |
| Number Of Medicare Beneficiaries | 1145 |
| Total Submitted Charge Amount | 1269791 |
| Total Medicare Allowed Amount | 210620.16 |
| Total Medicare Payment Amount | 163086.72 |
| Total Medicare Standardized Payment Amount | 170559.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 48 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 513 |
| Total Drug Medicare AllowedAmount | 108.13 |
| Total Drug Medicare PaymentAmount | 104.13 |
| Total Drug Medicare Standardized Payment Amount | 104.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 2111 |
| Number Of Medicare Beneficiaries With Medical Services | 1144 |
| Total Medical Submitted Charge Amount | 1269278 |
| Total Medical Medicare Allowed Amount | 210512.03 |
| Total Medical Medicare Payment Amount | 162982.59 |
| Total Medical Medicare Standardized Payment Amount | 170455.79 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 321 |
| Number Of Beneficiaries Age 65 to 74 | 364 |
| Number Of Beneficiaries Age 75 to 84 | 307 |
| Number Of Beneficiaries Age Greater 84 | 153 |
| Number Of Female Beneficiaries | 693 |
| Number Of Male Beneficiaries | 452 |
| Number Of Non Hispanic White Beneficiaries | 895 |
| Number Of Black or African American Beneficiaries | 131 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 30 |
| Number Of American Indian Alaska Native Beneficiaries | 67 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 779 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 366 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.8813 |