| National Provider Identifier [NPI]: | 1720014053 |
| Last Name Of The Provider | LEIDER |
| First Name Of The Provider | HOLLY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3003 W GOOD HOPE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MILWAUKEE |
| Zip Code Of The Provider | 532092042 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 82 |
| Number Of Services | 3171 |
| Number Of Medicare Beneficiaries | 407 |
| Total Submitted Charge Amount | 334196.09 |
| Total Medicare Allowed Amount | 92031.13 |
| Total Medicare Payment Amount | 72557.78 |
| Total Medicare Standardized Payment Amount | 75644.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 564 |
| Number Of Medicare Beneficiaries With Drug Services | 125 |
| Total Drug Submitted ChargeAmount | 13504.09 |
| Total Drug Medicare AllowedAmount | 3932.25 |
| Total Drug Medicare PaymentAmount | 3747.12 |
| Total Drug Medicare Standardized Payment Amount | 3747.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 69 |
| Number Of Medical Services | 2607 |
| Number Of Medicare Beneficiaries With Medical Services | 407 |
| Total Medical Submitted Charge Amount | 320692 |
| Total Medical Medicare Allowed Amount | 88098.88 |
| Total Medical Medicare Payment Amount | 68810.66 |
| Total Medical Medicare Standardized Payment Amount | 71897.22 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 61 |
| Number Of Beneficiaries Age 65 to 74 | 155 |
| Number Of Beneficiaries Age 75 to 84 | 111 |
| Number Of Beneficiaries Age Greater 84 | 80 |
| Number Of Female Beneficiaries | 293 |
| Number Of Male Beneficiaries | 114 |
| Number Of Non Hispanic White Beneficiaries | 251 |
| Number Of Black or African American Beneficiaries | 135 |
| 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 | 335 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 72 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2227 |