| National Provider Identifier [NPI]: | 1154405645 |
| Last Name Of The Provider | LEROY |
| First Name Of The Provider | BRENDAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 545 VITALITY DR |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | FORTVILLE |
| Zip Code Of The Provider | 460401373 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 1538 |
| Number Of Medicare Beneficiaries | 352 |
| Total Submitted Charge Amount | 140437 |
| Total Medicare Allowed Amount | 99198.86 |
| Total Medicare Payment Amount | 70939.94 |
| Total Medicare Standardized Payment Amount | 75894.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 156 |
| Number Of Medicare Beneficiaries With Drug Services | 105 |
| Total Drug Submitted ChargeAmount | 9807 |
| Total Drug Medicare AllowedAmount | 6517.69 |
| Total Drug Medicare PaymentAmount | 6085.31 |
| Total Drug Medicare Standardized Payment Amount | 6085.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 1382 |
| Number Of Medicare Beneficiaries With Medical Services | 352 |
| Total Medical Submitted Charge Amount | 130630 |
| Total Medical Medicare Allowed Amount | 92681.17 |
| Total Medical Medicare Payment Amount | 64854.63 |
| Total Medical Medicare Standardized Payment Amount | 69809.61 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 34 |
| Number Of Beneficiaries Age 65 to 74 | 167 |
| Number Of Beneficiaries Age 75 to 84 | 103 |
| Number Of Beneficiaries Age Greater 84 | 48 |
| Number Of Female Beneficiaries | 206 |
| Number Of Male Beneficiaries | 146 |
| 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 | 316 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 36 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0791 |