| National Provider Identifier [NPI]: | 1518073535 |
| Last Name Of The Provider | LEVENSON |
| First Name Of The Provider | ILENE |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8614 BAYMEADOWS WAY # 100 |
| Street Address 2 Of The Provider | |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322568236 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 85 |
| Number Of Services | 7889 |
| Number Of Medicare Beneficiaries | 438 |
| Total Submitted Charge Amount | 474293.2 |
| Total Medicare Allowed Amount | 250001.6 |
| Total Medicare Payment Amount | 196121.11 |
| Total Medicare Standardized Payment Amount | 198053.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 2151 |
| Number Of Medicare Beneficiaries With Drug Services | 241 |
| Total Drug Submitted ChargeAmount | 58400.2 |
| Total Drug Medicare AllowedAmount | 34838.54 |
| Total Drug Medicare PaymentAmount | 29012.67 |
| Total Drug Medicare Standardized Payment Amount | 29012.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 5738 |
| Number Of Medicare Beneficiaries With Medical Services | 438 |
| Total Medical Submitted Charge Amount | 415893 |
| Total Medical Medicare Allowed Amount | 215163.06 |
| Total Medical Medicare Payment Amount | 167108.44 |
| Total Medical Medicare Standardized Payment Amount | 169041.11 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 190 |
| Number Of Beneficiaries Age 75 to 84 | 151 |
| Number Of Beneficiaries Age Greater 84 | 81 |
| Number Of Female Beneficiaries | 339 |
| Number Of Male Beneficiaries | 99 |
| Number Of Non Hispanic White Beneficiaries | 403 |
| Number Of Black or African American Beneficiaries | 16 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0243 |