| National Provider Identifier [NPI]: | 1497759120 |
| Last Name Of The Provider | LEAHY |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12554 RIATA VISTA CIR |
| Street Address 2 Of The Provider | |
| City Of The Provider | AUSTIN |
| Zip Code Of The Provider | 787276431 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 205 |
| Number Of Services | 12877 |
| Number Of Medicare Beneficiaries | 2421 |
| Total Submitted Charge Amount | 2035138.1 |
| Total Medicare Allowed Amount | 745382.16 |
| Total Medicare Payment Amount | 574135.63 |
| Total Medicare Standardized Payment Amount | 577420.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 9135 |
| Number Of Medicare Beneficiaries With Drug Services | 117 |
| Total Drug Submitted ChargeAmount | 38986.1 |
| Total Drug Medicare AllowedAmount | 16547.77 |
| Total Drug Medicare PaymentAmount | 12953.03 |
| Total Drug Medicare Standardized Payment Amount | 12953.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 196 |
| Number Of Medical Services | 3742 |
| Number Of Medicare Beneficiaries With Medical Services | 2420 |
| Total Medical Submitted Charge Amount | 1996152 |
| Total Medical Medicare Allowed Amount | 728834.39 |
| Total Medical Medicare Payment Amount | 561182.6 |
| Total Medical Medicare Standardized Payment Amount | 564467.35 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 403 |
| Number Of Beneficiaries Age 65 to 74 | 974 |
| Number Of Beneficiaries Age 75 to 84 | 719 |
| Number Of Beneficiaries Age Greater 84 | 325 |
| Number Of Female Beneficiaries | 1406 |
| Number Of Male Beneficiaries | 1015 |
| Number Of Non Hispanic White Beneficiaries | 1788 |
| Number Of Black or African American Beneficiaries | 250 |
| Number Of AsianPacific Islander Beneficiaries | 35 |
| Number Of Hispanic Beneficiaries | 324 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1880 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 541 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.8383 |