| National Provider Identifier [NPI]: | 1255403176 |
| Last Name Of The Provider | LEUSNER |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1304 FAWCETT AVE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | TACOMA |
| Zip Code Of The Provider | 984021911 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 153 |
| Number Of Services | 6296 |
| Number Of Medicare Beneficiaries | 3683 |
| Total Submitted Charge Amount | 703601 |
| Total Medicare Allowed Amount | 189097.91 |
| Total Medicare Payment Amount | 137170.49 |
| Total Medicare Standardized Payment Amount | 140339.04 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 943 |
| Number Of Beneficiaries Age 65 to 74 | 1112 |
| Number Of Beneficiaries Age 75 to 84 | 969 |
| Number Of Beneficiaries Age Greater 84 | 659 |
| Number Of Female Beneficiaries | 2016 |
| Number Of Male Beneficiaries | 1667 |
| Number Of Non Hispanic White Beneficiaries | 2859 |
| Number Of Black or African American Beneficiaries | 332 |
| Number Of AsianPacific Islander Beneficiaries | 235 |
| Number Of Hispanic Beneficiaries | 115 |
| Number Of American Indian Alaska Native Beneficiaries | 73 |
| Number Of Beneficiaries With Race Not Else where Classified | 69 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2352 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1331 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.9554 |