National Provider Identifier [NPI]: |
1760562177 |
Last Name Of The Provider |
LEONARD |
First Name Of The Provider |
RONALD |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
235 EAST PENN AVENUE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROSEVILLE |
Zip Code Of The Provider |
61473 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
77 |
Number Of Services |
4500 |
Number Of Medicare Beneficiaries |
410 |
Total Submitted Charge Amount |
491583 |
Total Medicare Allowed Amount |
222999.62 |
Total Medicare Payment Amount |
153869.89 |
Total Medicare Standardized Payment Amount |
160049.25 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
14 |
Number Of Drug Services |
1080 |
Number Of Medicare Beneficiaries With Drug Services |
183 |
Total Drug Submitted ChargeAmount |
19701 |
Total Drug Medicare AllowedAmount |
6295.93 |
Total Drug Medicare PaymentAmount |
5673.76 |
Total Drug Medicare Standardized Payment Amount |
5673.76 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
63 |
Number Of Medical Services |
3420 |
Number Of Medicare Beneficiaries With Medical Services |
410 |
Total Medical Submitted Charge Amount |
471882 |
Total Medical Medicare Allowed Amount |
216703.69 |
Total Medical Medicare Payment Amount |
148196.13 |
Total Medical Medicare Standardized Payment Amount |
154375.49 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
52 |
Number Of Beneficiaries Age 65 to 74 |
150 |
Number Of Beneficiaries Age 75 to 84 |
129 |
Number Of Beneficiaries Age Greater 84 |
79 |
Number Of Female Beneficiaries |
232 |
Number Of Male Beneficiaries |
178 |
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 |
326 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
84 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.2797 |