| National Provider Identifier [NPI]: | 1255372900 |
| Last Name Of The Provider | LEADBETTER |
| First Name Of The Provider | LARRY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 705 PLEASANT AVE S |
| Street Address 2 Of The Provider | |
| City Of The Provider | PARK RAPIDS |
| Zip Code Of The Provider | 564701440 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 161 |
| Number Of Services | 12955 |
| Number Of Medicare Beneficiaries | 635 |
| Total Submitted Charge Amount | 500184.26 |
| Total Medicare Allowed Amount | 203109.62 |
| Total Medicare Payment Amount | 155797.75 |
| Total Medicare Standardized Payment Amount | 156330.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 37 |
| Number Of Drug Services | 8639 |
| Number Of Medicare Beneficiaries With Drug Services | 90 |
| Total Drug Submitted ChargeAmount | 113686.5 |
| Total Drug Medicare AllowedAmount | 84871.63 |
| Total Drug Medicare PaymentAmount | 66779.72 |
| Total Drug Medicare Standardized Payment Amount | 66779.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 124 |
| Number Of Medical Services | 4316 |
| Number Of Medicare Beneficiaries With Medical Services | 635 |
| Total Medical Submitted Charge Amount | 386497.76 |
| Total Medical Medicare Allowed Amount | 118237.99 |
| Total Medical Medicare Payment Amount | 89018.03 |
| Total Medical Medicare Standardized Payment Amount | 89550.79 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 102 |
| Number Of Beneficiaries Age 65 to 74 | 235 |
| Number Of Beneficiaries Age 75 to 84 | 204 |
| Number Of Beneficiaries Age Greater 84 | 94 |
| Number Of Female Beneficiaries | 328 |
| Number Of Male Beneficiaries | 307 |
| 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 | 512 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 123 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2538 |