| National Provider Identifier [NPI]: | 1013902907 |
| Last Name Of The Provider | LEICHT |
| First Name Of The Provider | STUART |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 329 N STATE OF FRANKLIN RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | JOHNSON CITY |
| Zip Code Of The Provider | 376046062 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 110 |
| Number Of Services | 5405 |
| Number Of Medicare Beneficiaries | 750 |
| Total Submitted Charge Amount | 638071 |
| Total Medicare Allowed Amount | 281641.91 |
| Total Medicare Payment Amount | 204111.05 |
| Total Medicare Standardized Payment Amount | 221481.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 441 |
| Number Of Medicare Beneficiaries With Drug Services | 77 |
| Total Drug Submitted ChargeAmount | 22319 |
| Total Drug Medicare AllowedAmount | 19317.79 |
| Total Drug Medicare PaymentAmount | 14868.38 |
| Total Drug Medicare Standardized Payment Amount | 14868.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 106 |
| Number Of Medical Services | 4964 |
| Number Of Medicare Beneficiaries With Medical Services | 750 |
| Total Medical Submitted Charge Amount | 615752 |
| Total Medical Medicare Allowed Amount | 262324.12 |
| Total Medical Medicare Payment Amount | 189242.67 |
| Total Medical Medicare Standardized Payment Amount | 206612.66 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 75 |
| Number Of Beneficiaries Age 65 to 74 | 318 |
| Number Of Beneficiaries Age 75 to 84 | 253 |
| Number Of Beneficiaries Age Greater 84 | 104 |
| Number Of Female Beneficiaries | 361 |
| Number Of Male Beneficiaries | 389 |
| Number Of Non Hispanic White Beneficiaries | 725 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 668 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 82 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0892 |