National Provider Identifier [NPI]: |
1477626869 |
Last Name Of The Provider |
LEONARDI |
First Name Of The Provider |
CRAIG |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1034 S BRENTWOOD BLVD |
Street Address 2 Of The Provider |
SUITE 600 |
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631171206 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
40 |
Number Of Services |
4890 |
Number Of Medicare Beneficiaries |
300 |
Total Submitted Charge Amount |
387055.26 |
Total Medicare Allowed Amount |
324695.54 |
Total Medicare Payment Amount |
246153.35 |
Total Medicare Standardized Payment Amount |
247690.87 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
3206 |
Number Of Medicare Beneficiaries With Drug Services |
38 |
Total Drug Submitted ChargeAmount |
246349.26 |
Total Drug Medicare AllowedAmount |
227641.55 |
Total Drug Medicare PaymentAmount |
178347.54 |
Total Drug Medicare Standardized Payment Amount |
178347.54 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
35 |
Number Of Medical Services |
1684 |
Number Of Medicare Beneficiaries With Medical Services |
300 |
Total Medical Submitted Charge Amount |
140706 |
Total Medical Medicare Allowed Amount |
97053.99 |
Total Medical Medicare Payment Amount |
67805.81 |
Total Medical Medicare Standardized Payment Amount |
69343.33 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
164 |
Number Of Beneficiaries Age 75 to 84 |
78 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
125 |
Number Of Male Beneficiaries |
175 |
Number Of Non Hispanic White Beneficiaries |
260 |
Number Of Black or African American Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
283 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
17 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9622 |