| National Provider Identifier [NPI]: | 1396735528 |
| Last Name Of The Provider | LILLY |
| First Name Of The Provider | LEONARD |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1153 CENTRE ST |
| Street Address 2 Of The Provider | SUITE 4930 |
| City Of The Provider | JAMAICA PLAIN |
| Zip Code Of The Provider | 021303446 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 3323 |
| Number Of Medicare Beneficiaries | 1312 |
| Total Submitted Charge Amount | 685384 |
| Total Medicare Allowed Amount | 190718.29 |
| Total Medicare Payment Amount | 139181.83 |
| Total Medicare Standardized Payment Amount | 130762.94 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Number Of Medicare Beneficiaries With Medical Services | |
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| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 133 |
| Number Of Beneficiaries Age 65 to 74 | 495 |
| Number Of Beneficiaries Age 75 to 84 | 467 |
| Number Of Beneficiaries Age Greater 84 | 217 |
| Number Of Female Beneficiaries | 666 |
| Number Of Male Beneficiaries | 646 |
| Number Of Non Hispanic White Beneficiaries | 1144 |
| Number Of Black or African American Beneficiaries | 70 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 44 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 35 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1085 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 227 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6751 |