| National Provider Identifier [NPI]: | 1780794933 |
| Last Name Of The Provider | HARRISON |
| First Name Of The Provider | LESLIE |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12961 27TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHIPPEWA FLS |
| Zip Code Of The Provider | 547295699 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 109 |
| Number Of Services | 2993 |
| Number Of Medicare Beneficiaries | 393 |
| Total Submitted Charge Amount | 498457.27 |
| Total Medicare Allowed Amount | 124648.43 |
| Total Medicare Payment Amount | 91955.17 |
| Total Medicare Standardized Payment Amount | 95763 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 264 |
| Number Of Medicare Beneficiaries With Drug Services | 147 |
| Total Drug Submitted ChargeAmount | 3983.03 |
| Total Drug Medicare AllowedAmount | 3036.86 |
| Total Drug Medicare PaymentAmount | 2873.8 |
| Total Drug Medicare Standardized Payment Amount | 2873.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 100 |
| Number Of Medical Services | 2729 |
| Number Of Medicare Beneficiaries With Medical Services | 393 |
| Total Medical Submitted Charge Amount | 494474.24 |
| Total Medical Medicare Allowed Amount | 121611.57 |
| Total Medical Medicare Payment Amount | 89081.37 |
| Total Medical Medicare Standardized Payment Amount | 92889.2 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 151 |
| Number Of Beneficiaries Age 75 to 84 | 130 |
| Number Of Beneficiaries Age Greater 84 | 84 |
| Number Of Female Beneficiaries | 213 |
| Number Of Male Beneficiaries | 180 |
| 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 | 355 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 38 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9731 |