| National Provider Identifier [NPI]: | 1851623730 |
| Last Name Of The Provider | LEUENBERGER |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | ARNP |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 101 JB SHANNON DR |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | FLEMINGSBURG |
| Zip Code Of The Provider | 410419812 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 1726 |
| Number Of Medicare Beneficiaries | 193 |
| Total Submitted Charge Amount | 332872 |
| Total Medicare Allowed Amount | 101118.85 |
| Total Medicare Payment Amount | 76746.59 |
| Total Medicare Standardized Payment Amount | 89656.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 439 |
| Number Of Medicare Beneficiaries With Drug Services | 66 |
| Total Drug Submitted ChargeAmount | 47375 |
| Total Drug Medicare AllowedAmount | 20242.61 |
| Total Drug Medicare PaymentAmount | 15708.77 |
| Total Drug Medicare Standardized Payment Amount | 15708.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 1287 |
| Number Of Medicare Beneficiaries With Medical Services | 193 |
| Total Medical Submitted Charge Amount | 285497 |
| Total Medical Medicare Allowed Amount | 80876.24 |
| Total Medical Medicare Payment Amount | 61037.82 |
| Total Medical Medicare Standardized Payment Amount | 73947.77 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 86 |
| Number Of Beneficiaries Age 65 to 74 | 65 |
| Number Of Beneficiaries Age 75 to 84 | 31 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 113 |
| Number Of Male Beneficiaries | 80 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 103 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 90 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1788 |