| National Provider Identifier [NPI]: | 1326138355 |
| Last Name Of The Provider | LEIBOLD |
| First Name Of The Provider | SCOTT |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | D.P.M |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2107 PICKWICK DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | CAMARILLO |
| Zip Code Of The Provider | 930106427 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 15 |
| Number Of Services | 14122 |
| Number Of Medicare Beneficiaries | 2551 |
| Total Submitted Charge Amount | 706840 |
| Total Medicare Allowed Amount | 481889.51 |
| Total Medicare Payment Amount | 376527.03 |
| Total Medicare Standardized Payment Amount | 363748.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 14122 |
| Number Of Medicare Beneficiaries With Medical Services | 2551 |
| Total Medical Submitted Charge Amount | 706840 |
| Total Medical Medicare Allowed Amount | 481889.51 |
| Total Medical Medicare Payment Amount | 376527.03 |
| Total Medical Medicare Standardized Payment Amount | 363748.17 |
| Average Age Of Beneficiaries | 81 |
| Number Of Beneficiaries Age Less65 | 249 |
| Number Of Beneficiaries Age 65 to 74 | 417 |
| Number Of Beneficiaries Age 75 to 84 | 687 |
| Number Of Beneficiaries Age Greater 84 | 1198 |
| Number Of Female Beneficiaries | 1658 |
| Number Of Male Beneficiaries | 893 |
| Number Of Non Hispanic White Beneficiaries | 703 |
| Number Of Black or African American Beneficiaries | 161 |
| Number Of AsianPacific Islander Beneficiaries | 1115 |
| Number Of Hispanic Beneficiaries | 522 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 104 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2447 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 75 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 62 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 25 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 34 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 3.0501 |