National Provider Identifier [NPI]: |
1154498384 |
Last Name Of The Provider |
LEVIN |
First Name Of The Provider |
JACQUELINE |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
P.A-C, MPH |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6050 CATTLERIDGE BLVD STE 201 |
Street Address 2 Of The Provider |
|
City Of The Provider |
SARASOTA |
Zip Code Of The Provider |
342326028 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
432 |
Number Of Medicare Beneficiaries |
186 |
Total Submitted Charge Amount |
55446.5 |
Total Medicare Allowed Amount |
18225.26 |
Total Medicare Payment Amount |
12281.32 |
Total Medicare Standardized Payment Amount |
14521.24 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
122 |
Number Of Medicare Beneficiaries With Drug Services |
32 |
Total Drug Submitted ChargeAmount |
1970 |
Total Drug Medicare AllowedAmount |
972.92 |
Total Drug Medicare PaymentAmount |
745.58 |
Total Drug Medicare Standardized Payment Amount |
745.58 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
310 |
Number Of Medicare Beneficiaries With Medical Services |
186 |
Total Medical Submitted Charge Amount |
53476.5 |
Total Medical Medicare Allowed Amount |
17252.34 |
Total Medical Medicare Payment Amount |
11535.74 |
Total Medical Medicare Standardized Payment Amount |
13775.66 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
69 |
Number Of Beneficiaries Age 75 to 84 |
88 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
122 |
Number Of Male Beneficiaries |
64 |
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 |
15 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
17 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0389 |