| National Provider Identifier [NPI]: | 1639151871 |
| Last Name Of The Provider | LEAN |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1903 W MICHIGAN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | KALAMAZOO |
| Zip Code Of The Provider | 490085200 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 173 |
| Number Of Medicare Beneficiaries | 71 |
| Total Submitted Charge Amount | 3828.75 |
| Total Medicare Allowed Amount | 3257.06 |
| Total Medicare Payment Amount | 2699.75 |
| Total Medicare Standardized Payment Amount | 3658.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 64 |
| Number Of Medicare Beneficiaries With Drug Services | 62 |
| Total Drug Submitted ChargeAmount | 770.62 |
| Total Drug Medicare AllowedAmount | 746 |
| Total Drug Medicare PaymentAmount | 731.07 |
| Total Drug Medicare Standardized Payment Amount | 731.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 109 |
| Number Of Medicare Beneficiaries With Medical Services | 70 |
| Total Medical Submitted Charge Amount | 3058.13 |
| Total Medical Medicare Allowed Amount | 2511.06 |
| Total Medical Medicare Payment Amount | 1968.68 |
| Total Medical Medicare Standardized Payment Amount | 2927.42 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 31 |
| Number Of Beneficiaries Age 75 to 84 | 29 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 31 |
| Number Of Male Beneficiaries | 40 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 45 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9663 |