| National Provider Identifier [NPI]: | 1942341854 |
| Last Name Of The Provider | LE |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2410 FIRE MESA ST |
| Street Address 2 Of The Provider | #160 |
| City Of The Provider | LAS VEGAS |
| Zip Code Of The Provider | 891289016 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 8709 |
| Number Of Medicare Beneficiaries | 475 |
| Total Submitted Charge Amount | 2596136 |
| Total Medicare Allowed Amount | 526381.76 |
| Total Medicare Payment Amount | 389767.78 |
| Total Medicare Standardized Payment Amount | 370976.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 3943 |
| Number Of Medicare Beneficiaries With Drug Services | 227 |
| Total Drug Submitted ChargeAmount | 15827 |
| Total Drug Medicare AllowedAmount | 1502.39 |
| Total Drug Medicare PaymentAmount | 1132.04 |
| Total Drug Medicare Standardized Payment Amount | 1132.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 4766 |
| Number Of Medicare Beneficiaries With Medical Services | 475 |
| Total Medical Submitted Charge Amount | 2580309 |
| Total Medical Medicare Allowed Amount | 524879.37 |
| Total Medical Medicare Payment Amount | 388635.74 |
| Total Medical Medicare Standardized Payment Amount | 369843.99 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 175 |
| Number Of Beneficiaries Age 65 to 74 | 166 |
| Number Of Beneficiaries Age 75 to 84 | 101 |
| Number Of Beneficiaries Age Greater 84 | 33 |
| Number Of Female Beneficiaries | 327 |
| Number Of Male Beneficiaries | 148 |
| Number Of Non Hispanic White Beneficiaries | 333 |
| Number Of Black or African American Beneficiaries | 78 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 36 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 351 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 124 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.6702 |