| National Provider Identifier [NPI]: | 1558362277 |
| Last Name Of The Provider | LEARY |
| First Name Of The Provider | PATRICK |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5401 PEACH ST |
| Street Address 2 Of The Provider | SUITE 3400 |
| City Of The Provider | ERIE |
| Zip Code Of The Provider | 165092601 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Sports Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 16 |
| Number Of Services | 363 |
| Number Of Medicare Beneficiaries | 46 |
| Total Submitted Charge Amount | 59605 |
| Total Medicare Allowed Amount | 32776.34 |
| Total Medicare Payment Amount | 24772.43 |
| Total Medicare Standardized Payment Amount | 24797.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 94 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 23532 |
| Total Drug Medicare AllowedAmount | 12297.77 |
| Total Drug Medicare PaymentAmount | 9627.57 |
| Total Drug Medicare Standardized Payment Amount | 9627.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 13 |
| Number Of Medical Services | 269 |
| Number Of Medicare Beneficiaries With Medical Services | 46 |
| Total Medical Submitted Charge Amount | 36073 |
| Total Medical Medicare Allowed Amount | 20478.57 |
| Total Medical Medicare Payment Amount | 15144.86 |
| Total Medical Medicare Standardized Payment Amount | 15170.11 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 30 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 29 |
| Number Of Male Beneficiaries | 17 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 0.8837 |