| National Provider Identifier [NPI]: | 1043379944 |
| Last Name Of The Provider | LEACH |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2500 W A ST |
| Street Address 2 Of The Provider | SUITE 202 |
| City Of The Provider | MOSCOW |
| Zip Code Of The Provider | 838436000 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 6507 |
| Number Of Medicare Beneficiaries | 1140 |
| Total Submitted Charge Amount | 2144857 |
| Total Medicare Allowed Amount | 966692.45 |
| Total Medicare Payment Amount | 722471.8 |
| Total Medicare Standardized Payment Amount | 760381.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 1314 |
| Number Of Medicare Beneficiaries With Drug Services | 142 |
| Total Drug Submitted ChargeAmount | 298178 |
| Total Drug Medicare AllowedAmount | 270900.77 |
| Total Drug Medicare PaymentAmount | 212259 |
| Total Drug Medicare Standardized Payment Amount | 212259 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 5193 |
| Number Of Medicare Beneficiaries With Medical Services | 1140 |
| Total Medical Submitted Charge Amount | 1846679 |
| Total Medical Medicare Allowed Amount | 695791.68 |
| Total Medical Medicare Payment Amount | 510212.8 |
| Total Medical Medicare Standardized Payment Amount | 548122.42 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 454 |
| Number Of Beneficiaries Age 75 to 84 | 429 |
| Number Of Beneficiaries Age Greater 84 | 214 |
| Number Of Female Beneficiaries | 650 |
| Number Of Male Beneficiaries | 490 |
| Number Of Non Hispanic White Beneficiaries | 1104 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 14 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1046 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 94 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9743 |