| National Provider Identifier [NPI]: | 1134214786 |
| Last Name Of The Provider | LEVIN |
| First Name Of The Provider | DAYNA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 800 SPRUCE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191076130 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 92 |
| Number Of Services | 3010 |
| Number Of Medicare Beneficiaries | 1504 |
| Total Submitted Charge Amount | 225529 |
| Total Medicare Allowed Amount | 69068.07 |
| Total Medicare Payment Amount | 55926.03 |
| Total Medicare Standardized Payment Amount | 53782.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 301 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 2677 |
| Total Drug Medicare AllowedAmount | 665.99 |
| Total Drug Medicare PaymentAmount | 522.16 |
| Total Drug Medicare Standardized Payment Amount | 522.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 90 |
| Number Of Medical Services | 2709 |
| Number Of Medicare Beneficiaries With Medical Services | 1504 |
| Total Medical Submitted Charge Amount | 222852 |
| Total Medical Medicare Allowed Amount | 68402.08 |
| Total Medical Medicare Payment Amount | 55403.87 |
| Total Medical Medicare Standardized Payment Amount | 53260.2 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 267 |
| Number Of Beneficiaries Age 65 to 74 | 732 |
| Number Of Beneficiaries Age 75 to 84 | 364 |
| Number Of Beneficiaries Age Greater 84 | 141 |
| Number Of Female Beneficiaries | 1057 |
| Number Of Male Beneficiaries | 447 |
| Number Of Non Hispanic White Beneficiaries | 1015 |
| Number Of Black or African American Beneficiaries | 390 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1177 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 327 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6356 |