| National Provider Identifier [NPI]: | 1982793287 |
| Last Name Of The Provider | SPACCAVENTO |
| First Name Of The Provider | LEO |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4275 BURNHAM AVE |
| Street Address 2 Of The Provider | SUITE 220 |
| City Of The Provider | LAS VEGAS |
| Zip Code Of The Provider | 891195488 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 74 |
| Number Of Services | 9659 |
| Number Of Medicare Beneficiaries | 2444 |
| Total Submitted Charge Amount | 1686457 |
| Total Medicare Allowed Amount | 799064.15 |
| Total Medicare Payment Amount | 584434.23 |
| Total Medicare Standardized Payment Amount | 580109.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 1509 |
| Number Of Medicare Beneficiaries With Drug Services | 362 |
| Total Drug Submitted ChargeAmount | 55223 |
| Total Drug Medicare AllowedAmount | 7677.29 |
| Total Drug Medicare PaymentAmount | 6024.68 |
| Total Drug Medicare Standardized Payment Amount | 6024.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 67 |
| Number Of Medical Services | 8150 |
| Number Of Medicare Beneficiaries With Medical Services | 2444 |
| Total Medical Submitted Charge Amount | 1631234 |
| Total Medical Medicare Allowed Amount | 791386.86 |
| Total Medical Medicare Payment Amount | 578409.55 |
| Total Medical Medicare Standardized Payment Amount | 574085.13 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 339 |
| Number Of Beneficiaries Age 65 to 74 | 1043 |
| Number Of Beneficiaries Age 75 to 84 | 734 |
| Number Of Beneficiaries Age Greater 84 | 328 |
| Number Of Female Beneficiaries | 1127 |
| Number Of Male Beneficiaries | 1317 |
| Number Of Non Hispanic White Beneficiaries | 1916 |
| Number Of Black or African American Beneficiaries | 201 |
| Number Of AsianPacific Islander Beneficiaries | 81 |
| Number Of Hispanic Beneficiaries | 194 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1982 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 462 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7828 |