| National Provider Identifier [NPI]: | 1215101845 |
| Last Name Of The Provider | LEBOYER |
| First Name Of The Provider | RUSSELL |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D, |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9630 KENTON AVENUE EYE CARE LTD. |
| Street Address 2 Of The Provider | EYE CARE LTD. |
| City Of The Provider | SKOKIE |
| Zip Code Of The Provider | 60076 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 1774 |
| Number Of Medicare Beneficiaries | 751 |
| Total Submitted Charge Amount | 421260 |
| Total Medicare Allowed Amount | 238928.05 |
| Total Medicare Payment Amount | 174341.18 |
| Total Medicare Standardized Payment Amount | 161455.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 1774 |
| Number Of Medicare Beneficiaries With Medical Services | 751 |
| Total Medical Submitted Charge Amount | 421260 |
| Total Medical Medicare Allowed Amount | 238928.05 |
| Total Medical Medicare Payment Amount | 174341.18 |
| Total Medical Medicare Standardized Payment Amount | 161455.48 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 300 |
| Number Of Beneficiaries Age 75 to 84 | 268 |
| Number Of Beneficiaries Age Greater 84 | 153 |
| Number Of Female Beneficiaries | 470 |
| Number Of Male Beneficiaries | 281 |
| Number Of Non Hispanic White Beneficiaries | 669 |
| Number Of Black or African American Beneficiaries | 18 |
| Number Of AsianPacific Islander Beneficiaries | 27 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 700 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 51 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0842 |