| National Provider Identifier [NPI]: | 1093785198 |
| Last Name Of The Provider | LIS |
| First Name Of The Provider | LEON |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 612 W DUARTE RD |
| Street Address 2 Of The Provider | STE 101 |
| City Of The Provider | ARCADIA |
| Zip Code Of The Provider | 910079220 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 238 |
| Number Of Services | 12679 |
| Number Of Medicare Beneficiaries | 4171 |
| Total Submitted Charge Amount | 1428903.29 |
| Total Medicare Allowed Amount | 400607.16 |
| Total Medicare Payment Amount | 306875.21 |
| Total Medicare Standardized Payment Amount | 282026.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 4228 |
| Number Of Medicare Beneficiaries With Drug Services | 79 |
| Total Drug Submitted ChargeAmount | 2464.75 |
| Total Drug Medicare AllowedAmount | 1699.54 |
| Total Drug Medicare PaymentAmount | 1332.47 |
| Total Drug Medicare Standardized Payment Amount | 1332.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 234 |
| Number Of Medical Services | 8451 |
| Number Of Medicare Beneficiaries With Medical Services | 4171 |
| Total Medical Submitted Charge Amount | 1426438.54 |
| Total Medical Medicare Allowed Amount | 398907.62 |
| Total Medical Medicare Payment Amount | 305542.74 |
| Total Medical Medicare Standardized Payment Amount | 280694.22 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 461 |
| Number Of Beneficiaries Age 65 to 74 | 1167 |
| Number Of Beneficiaries Age 75 to 84 | 1302 |
| Number Of Beneficiaries Age Greater 84 | 1241 |
| Number Of Female Beneficiaries | 2556 |
| Number Of Male Beneficiaries | 1615 |
| Number Of Non Hispanic White Beneficiaries | 1980 |
| Number Of Black or African American Beneficiaries | 163 |
| Number Of AsianPacific Islander Beneficiaries | 1058 |
| Number Of Hispanic Beneficiaries | 883 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2051 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2120 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 34 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 21 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.3852 |