| National Provider Identifier [NPI]: | 1770568594 |
| Last Name Of The Provider | LEENAY |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 300 LAKE DR E |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHANHASSEN |
| Zip Code Of The Provider | 553179302 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 1612 |
| Number Of Medicare Beneficiaries | 278 |
| Total Submitted Charge Amount | 131928.65 |
| Total Medicare Allowed Amount | 59977.54 |
| Total Medicare Payment Amount | 43607.57 |
| Total Medicare Standardized Payment Amount | 45708.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 138 |
| Number Of Medicare Beneficiaries With Drug Services | 96 |
| Total Drug Submitted ChargeAmount | 16200 |
| Total Drug Medicare AllowedAmount | 10085.85 |
| Total Drug Medicare PaymentAmount | 9865.6 |
| Total Drug Medicare Standardized Payment Amount | 9865.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 1474 |
| Number Of Medicare Beneficiaries With Medical Services | 278 |
| Total Medical Submitted Charge Amount | 115728.65 |
| Total Medical Medicare Allowed Amount | 49891.69 |
| Total Medical Medicare Payment Amount | 33741.97 |
| Total Medical Medicare Standardized Payment Amount | 35843.21 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 107 |
| Number Of Beneficiaries Age 75 to 84 | 105 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 131 |
| Number Of Male Beneficiaries | 147 |
| Number Of Non Hispanic White Beneficiaries | 267 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 27 |
| Percent Of With Hypertension | 41 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.8912 |