National Provider Identifier [NPI]: |
1336128859 |
Last Name Of The Provider |
LEVINE |
First Name Of The Provider |
TODD |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5090 N. 40TH ST |
Street Address 2 Of The Provider |
STE 250 |
City Of The Provider |
PHOENIX |
Zip Code Of The Provider |
850182134 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
56 |
Number Of Services |
16912 |
Number Of Medicare Beneficiaries |
383 |
Total Submitted Charge Amount |
1940237.84 |
Total Medicare Allowed Amount |
484304.94 |
Total Medicare Payment Amount |
375229.92 |
Total Medicare Standardized Payment Amount |
374766.61 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
15577 |
Number Of Medicare Beneficiaries With Drug Services |
19 |
Total Drug Submitted ChargeAmount |
1744652.84 |
Total Drug Medicare AllowedAmount |
361915.14 |
Total Drug Medicare PaymentAmount |
283741.41 |
Total Drug Medicare Standardized Payment Amount |
283741.41 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
49 |
Number Of Medical Services |
1335 |
Number Of Medicare Beneficiaries With Medical Services |
383 |
Total Medical Submitted Charge Amount |
195585 |
Total Medical Medicare Allowed Amount |
122389.8 |
Total Medical Medicare Payment Amount |
91488.51 |
Total Medical Medicare Standardized Payment Amount |
91025.2 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
86 |
Number Of Beneficiaries Age 65 to 74 |
174 |
Number Of Beneficiaries Age 75 to 84 |
90 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
196 |
Number Of Male Beneficiaries |
187 |
Number Of Non Hispanic White Beneficiaries |
332 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
22 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
330 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
53 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.4643 |