| National Provider Identifier [NPI]: | 1649248212 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | WENDY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 600 RIDGELY AVE |
| Street Address 2 Of The Provider | SUITE 123 |
| City Of The Provider | ANNAPOLIS |
| Zip Code Of The Provider | 214011001 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 10205 |
| Number Of Medicare Beneficiaries | 3089 |
| Total Submitted Charge Amount | 955709.75 |
| Total Medicare Allowed Amount | 520251.43 |
| Total Medicare Payment Amount | 382724.03 |
| Total Medicare Standardized Payment Amount | 299279.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 25 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 6509.75 |
| Total Drug Medicare AllowedAmount | 4991.07 |
| Total Drug Medicare PaymentAmount | 3911.48 |
| Total Drug Medicare Standardized Payment Amount | 3911.48 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 10180 |
| Number Of Medicare Beneficiaries With Medical Services | 3089 |
| Total Medical Submitted Charge Amount | 949200 |
| Total Medical Medicare Allowed Amount | 515260.36 |
| Total Medical Medicare Payment Amount | 378812.55 |
| Total Medical Medicare Standardized Payment Amount | 295368.43 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 71 |
| Number Of Beneficiaries Age 65 to 74 | 1696 |
| Number Of Beneficiaries Age 75 to 84 | 990 |
| Number Of Beneficiaries Age Greater 84 | 332 |
| Number Of Female Beneficiaries | 1575 |
| Number Of Male Beneficiaries | 1514 |
| Number Of Non Hispanic White Beneficiaries | 2984 |
| Number Of Black or African American Beneficiaries | 27 |
| 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 | 57 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3036 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 53 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8581 |