| National Provider Identifier [NPI]: | 1780675934 |
| Last Name Of The Provider | LEVITOV |
| First Name Of The Provider | ALEXANDER |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 825 FAIRFAX AVE |
| Street Address 2 Of The Provider | SUITE 445 |
| City Of The Provider | NORFOLK |
| Zip Code Of The Provider | 235071914 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Critical Care (Intensivists) |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 9 |
| Number Of Services | 853 |
| Number Of Medicare Beneficiaries | 340 |
| Total Submitted Charge Amount | 283935 |
| Total Medicare Allowed Amount | 150805 |
| Total Medicare Payment Amount | 117888.65 |
| Total Medicare Standardized Payment Amount | 120268.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 9 |
| Number Of Medical Services | 853 |
| Number Of Medicare Beneficiaries With Medical Services | 340 |
| Total Medical Submitted Charge Amount | 283935 |
| Total Medical Medicare Allowed Amount | 150805 |
| Total Medical Medicare Payment Amount | 117888.65 |
| Total Medical Medicare Standardized Payment Amount | 120268.39 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 104 |
| Number Of Beneficiaries Age 65 to 74 | 107 |
| Number Of Beneficiaries Age 75 to 84 | 86 |
| Number Of Beneficiaries Age Greater 84 | 43 |
| Number Of Female Beneficiaries | 175 |
| Number Of Male Beneficiaries | 165 |
| Number Of Non Hispanic White Beneficiaries | 160 |
| Number Of Black or African American Beneficiaries | 163 |
| 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 | 189 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 151 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 36 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 52 |
| Percent Of With Chronic Kidney Disease | 70 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 56 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 19 |
| Percent Of With Stroke | 34 |
| Average HCC Risk Score Of Beneficiaries | 2.918 |