| National Provider Identifier [NPI]: | 1629059738 |
| Last Name Of The Provider | LEAVITT |
| First Name Of The Provider | RONALD |
| 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 | 12670 CREEKSIDE LN |
| Street Address 2 Of The Provider | SUITE 202 |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 339193370 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 986 |
| Number Of Medicare Beneficiaries | 260 |
| Total Submitted Charge Amount | 136305.32 |
| Total Medicare Allowed Amount | 57958.15 |
| Total Medicare Payment Amount | 40688.24 |
| Total Medicare Standardized Payment Amount | 38631.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 290 |
| Number Of Medicare Beneficiaries With Drug Services | 104 |
| Total Drug Submitted ChargeAmount | 7423.39 |
| Total Drug Medicare AllowedAmount | 3364.04 |
| Total Drug Medicare PaymentAmount | 2615.71 |
| Total Drug Medicare Standardized Payment Amount | 2615.71 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 696 |
| Number Of Medicare Beneficiaries With Medical Services | 260 |
| Total Medical Submitted Charge Amount | 128881.93 |
| Total Medical Medicare Allowed Amount | 54594.11 |
| Total Medical Medicare Payment Amount | 38072.53 |
| Total Medical Medicare Standardized Payment Amount | 36015.78 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 13 |
| Number Of Beneficiaries Age 65 to 74 | 153 |
| Number Of Beneficiaries Age 75 to 84 | 76 |
| Number Of Beneficiaries Age Greater 84 | 18 |
| Number Of Female Beneficiaries | 140 |
| Number Of Male Beneficiaries | 120 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| 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 | 13 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9242 |