| National Provider Identifier [NPI]: | 1356367353 |
| Last Name Of The Provider | LEVITSKY |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 820 N CHELAN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | WENATCHEE |
| Zip Code Of The Provider | 988012028 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 187 |
| Number Of Services | 6847 |
| Number Of Medicare Beneficiaries | 2816 |
| Total Submitted Charge Amount | 974594.42 |
| Total Medicare Allowed Amount | 280536.02 |
| Total Medicare Payment Amount | 214720.15 |
| Total Medicare Standardized Payment Amount | 218860.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 2845 |
| Number Of Medicare Beneficiaries With Drug Services | 160 |
| Total Drug Submitted ChargeAmount | 13726.58 |
| Total Drug Medicare AllowedAmount | 5240 |
| Total Drug Medicare PaymentAmount | 4041.27 |
| Total Drug Medicare Standardized Payment Amount | 4041.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 180 |
| Number Of Medical Services | 4002 |
| Number Of Medicare Beneficiaries With Medical Services | 2815 |
| Total Medical Submitted Charge Amount | 960867.84 |
| Total Medical Medicare Allowed Amount | 275296.02 |
| Total Medical Medicare Payment Amount | 210678.88 |
| Total Medical Medicare Standardized Payment Amount | 214819.27 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 399 |
| Number Of Beneficiaries Age 65 to 74 | 1103 |
| Number Of Beneficiaries Age 75 to 84 | 914 |
| Number Of Beneficiaries Age Greater 84 | 400 |
| Number Of Female Beneficiaries | 1640 |
| Number Of Male Beneficiaries | 1176 |
| Number Of Non Hispanic White Beneficiaries | 2579 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 149 |
| Number Of American Indian Alaska Native Beneficiaries | 40 |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2259 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 557 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2575 |