| National Provider Identifier [NPI]: | 1063404192 |
| Last Name Of The Provider | LEVITON |
| First Name Of The Provider | MICHAEL |
| 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 | 1701 AUGUSTINE CUT OFF |
| Street Address 2 Of The Provider | |
| City Of The Provider | WILMINGTON |
| Zip Code Of The Provider | 198034415 |
| State Code Of The Provider | DE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 169 |
| Number Of Services | 71321 |
| Number Of Medicare Beneficiaries | 3554 |
| Total Submitted Charge Amount | 4541499.4 |
| Total Medicare Allowed Amount | 915987.11 |
| Total Medicare Payment Amount | 708053.26 |
| Total Medicare Standardized Payment Amount | 706766.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 66137 |
| Number Of Medicare Beneficiaries With Drug Services | 787 |
| Total Drug Submitted ChargeAmount | 38118.4 |
| Total Drug Medicare AllowedAmount | 20141.32 |
| Total Drug Medicare PaymentAmount | 14592.16 |
| Total Drug Medicare Standardized Payment Amount | 14592.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 166 |
| Number Of Medical Services | 5184 |
| Number Of Medicare Beneficiaries With Medical Services | 3554 |
| Total Medical Submitted Charge Amount | 4503381 |
| Total Medical Medicare Allowed Amount | 895845.79 |
| Total Medical Medicare Payment Amount | 693461.1 |
| Total Medical Medicare Standardized Payment Amount | 692174.63 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 380 |
| Number Of Beneficiaries Age 65 to 74 | 1752 |
| Number Of Beneficiaries Age 75 to 84 | 1068 |
| Number Of Beneficiaries Age Greater 84 | 354 |
| Number Of Female Beneficiaries | 2285 |
| Number Of Male Beneficiaries | 1269 |
| Number Of Non Hispanic White Beneficiaries | 2938 |
| Number Of Black or African American Beneficiaries | 433 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 70 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 57 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3226 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 328 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0415 |