| National Provider Identifier [NPI]: | 1265435069 |
| Last Name Of The Provider | HALTRECHT |
| First Name Of The Provider | LEONARD |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1999 SPROUL RD |
| Street Address 2 Of The Provider | STE 21 |
| City Of The Provider | BROOMALL |
| Zip Code Of The Provider | 190083508 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 685 |
| Number Of Medicare Beneficiaries | 186 |
| Total Submitted Charge Amount | 53408 |
| Total Medicare Allowed Amount | 43423.5 |
| Total Medicare Payment Amount | 34704.01 |
| Total Medicare Standardized Payment Amount | 33000.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 80 |
| Number Of Medicare Beneficiaries With Drug Services | 66 |
| Total Drug Submitted ChargeAmount | 3248 |
| Total Drug Medicare AllowedAmount | 2778.69 |
| Total Drug Medicare PaymentAmount | 2722.74 |
| Total Drug Medicare Standardized Payment Amount | 2722.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 605 |
| Number Of Medicare Beneficiaries With Medical Services | 186 |
| Total Medical Submitted Charge Amount | 50160 |
| Total Medical Medicare Allowed Amount | 40644.81 |
| Total Medical Medicare Payment Amount | 31981.27 |
| Total Medical Medicare Standardized Payment Amount | 30278.11 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 13 |
| Number Of Beneficiaries Age 65 to 74 | 101 |
| Number Of Beneficiaries Age 75 to 84 | 48 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 90 |
| Number Of Male Beneficiaries | 96 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 8 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 41 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9875 |