| National Provider Identifier [NPI]: | 1093850927 |
| Last Name Of The Provider | LEAL |
| First Name Of The Provider | JORGE |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 825 N COURTENAY PKWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | MERRITT ISLAND |
| Zip Code Of The Provider | 329534652 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 5745 |
| Number Of Medicare Beneficiaries | 862 |
| Total Submitted Charge Amount | 542831 |
| Total Medicare Allowed Amount | 360785.65 |
| Total Medicare Payment Amount | 268192.21 |
| Total Medicare Standardized Payment Amount | 270851.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 82 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 21525 |
| Total Drug Medicare AllowedAmount | 17726.93 |
| Total Drug Medicare PaymentAmount | 13792.69 |
| Total Drug Medicare Standardized Payment Amount | 13792.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 5663 |
| Number Of Medicare Beneficiaries With Medical Services | 862 |
| Total Medical Submitted Charge Amount | 521306 |
| Total Medical Medicare Allowed Amount | 343058.72 |
| Total Medical Medicare Payment Amount | 254399.52 |
| Total Medical Medicare Standardized Payment Amount | 257058.69 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 322 |
| Number Of Beneficiaries Age 75 to 84 | 363 |
| Number Of Beneficiaries Age Greater 84 | 150 |
| Number Of Female Beneficiaries | 175 |
| Number Of Male Beneficiaries | 687 |
| Number Of Non Hispanic White Beneficiaries | 774 |
| Number Of Black or African American Beneficiaries | 41 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 29 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 827 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 35 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.29 |