| National Provider Identifier [NPI]: | 1821243759 |
| Last Name Of The Provider | LE |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4440 EUCLID AVE |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 921154522 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 983 |
| Number Of Medicare Beneficiaries | 304 |
| Total Submitted Charge Amount | 130955.4 |
| Total Medicare Allowed Amount | 83370.06 |
| Total Medicare Payment Amount | 64883.22 |
| Total Medicare Standardized Payment Amount | 63018.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 26 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 1325 |
| Total Drug Medicare AllowedAmount | 383.65 |
| Total Drug Medicare PaymentAmount | 376 |
| Total Drug Medicare Standardized Payment Amount | 376 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 957 |
| Number Of Medicare Beneficiaries With Medical Services | 304 |
| Total Medical Submitted Charge Amount | 129630.4 |
| Total Medical Medicare Allowed Amount | 82986.41 |
| Total Medical Medicare Payment Amount | 64507.22 |
| Total Medical Medicare Standardized Payment Amount | 62642.33 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 58 |
| Number Of Beneficiaries Age 65 to 74 | 113 |
| Number Of Beneficiaries Age 75 to 84 | 93 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 152 |
| Number Of Male Beneficiaries | 152 |
| Number Of Non Hispanic White Beneficiaries | 83 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 129 |
| Number Of Hispanic Beneficiaries | 61 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 30 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 274 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 38 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 19 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.8147 |