| National Provider Identifier [NPI]: | 1730148958 |
| Last Name Of The Provider | LEINWEBER |
| First Name Of The Provider | ELDON |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 32 MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MANSFIELD |
| Zip Code Of The Provider | 988300176 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 15 |
| Number Of Services | 354 |
| Number Of Medicare Beneficiaries | 52 |
| Total Submitted Charge Amount | 56031 |
| Total Medicare Allowed Amount | 28293.43 |
| Total Medicare Payment Amount | 20431.71 |
| Total Medicare Standardized Payment Amount | 24512.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 26 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 939 |
| Total Drug Medicare AllowedAmount | 51.34 |
| Total Drug Medicare PaymentAmount | 25.37 |
| Total Drug Medicare Standardized Payment Amount | 25.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 8 |
| Number Of Medical Services | 328 |
| Number Of Medicare Beneficiaries With Medical Services | 52 |
| Total Medical Submitted Charge Amount | 55092 |
| Total Medical Medicare Allowed Amount | 28242.09 |
| Total Medical Medicare Payment Amount | 20406.34 |
| Total Medical Medicare Standardized Payment Amount | 24487.05 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 18 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 24 |
| Number Of Male Beneficiaries | 28 |
| 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 | 37 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 15 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 0 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 29 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9342 |