| National Provider Identifier [NPI]: | 1437208410 |
| Last Name Of The Provider | LEITHLITER |
| First Name Of The Provider | STACEY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7 S HOSPITAL DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | MURPHYSBORO |
| Zip Code Of The Provider | 629663333 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 6354 |
| Number Of Medicare Beneficiaries | 277 |
| Total Submitted Charge Amount | 383487.17 |
| Total Medicare Allowed Amount | 120813.37 |
| Total Medicare Payment Amount | 91476.96 |
| Total Medicare Standardized Payment Amount | 97915.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 5157 |
| Number Of Medicare Beneficiaries With Drug Services | 57 |
| Total Drug Submitted ChargeAmount | 269286 |
| Total Drug Medicare AllowedAmount | 83355.06 |
| Total Drug Medicare PaymentAmount | 64525.88 |
| Total Drug Medicare Standardized Payment Amount | 64525.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 1197 |
| Number Of Medicare Beneficiaries With Medical Services | 277 |
| Total Medical Submitted Charge Amount | 114201.17 |
| Total Medical Medicare Allowed Amount | 37458.31 |
| Total Medical Medicare Payment Amount | 26951.08 |
| Total Medical Medicare Standardized Payment Amount | 33389.37 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 49 |
| Number Of Beneficiaries Age 65 to 74 | 105 |
| Number Of Beneficiaries Age 75 to 84 | 79 |
| Number Of Beneficiaries Age Greater 84 | 44 |
| Number Of Female Beneficiaries | 83 |
| Number Of Male Beneficiaries | 194 |
| 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 | 211 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 66 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5225 |