National Provider Identifier [NPI]: |
1811909005 |
Last Name Of The Provider |
LEEDY |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1135 JADWIN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
RICHLAND |
Zip Code Of The Provider |
993523434 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
40 |
Number Of Services |
1519 |
Number Of Medicare Beneficiaries |
506 |
Total Submitted Charge Amount |
191498.25 |
Total Medicare Allowed Amount |
113930.1 |
Total Medicare Payment Amount |
79375.02 |
Total Medicare Standardized Payment Amount |
81464.49 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
70 |
Number Of Beneficiaries Age 65 to 74 |
264 |
Number Of Beneficiaries Age 75 to 84 |
130 |
Number Of Beneficiaries Age Greater 84 |
42 |
Number Of Female Beneficiaries |
240 |
Number Of Male Beneficiaries |
266 |
Number Of Non Hispanic White Beneficiaries |
471 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
451 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
55 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
3 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.9455 |