| National Provider Identifier [NPI]: | 1437125408 |
| Last Name Of The Provider | LEVERENZ |
| First Name Of The Provider | BRENDA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1217 KEARNEY ST |
| Street Address 2 Of The Provider | SUITE 1 |
| City Of The Provider | PORT HURON |
| Zip Code Of The Provider | 480603571 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 772 |
| Number Of Medicare Beneficiaries | 288 |
| Total Submitted Charge Amount | 68021 |
| Total Medicare Allowed Amount | 44339.48 |
| Total Medicare Payment Amount | 34794.92 |
| Total Medicare Standardized Payment Amount | 42648.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 40 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 1145 |
| Total Drug Medicare AllowedAmount | 530.19 |
| Total Drug Medicare PaymentAmount | 492.84 |
| Total Drug Medicare Standardized Payment Amount | 492.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 732 |
| Number Of Medicare Beneficiaries With Medical Services | 287 |
| Total Medical Submitted Charge Amount | 66876 |
| Total Medical Medicare Allowed Amount | 43809.29 |
| Total Medical Medicare Payment Amount | 34302.08 |
| Total Medical Medicare Standardized Payment Amount | 42155.28 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 75 |
| Number Of Beneficiaries Age 65 to 74 | 88 |
| Number Of Beneficiaries Age 75 to 84 | 93 |
| Number Of Beneficiaries Age Greater 84 | 32 |
| Number Of Female Beneficiaries | 169 |
| Number Of Male Beneficiaries | 119 |
| Number Of Non Hispanic White Beneficiaries | 276 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 227 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 61 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.2049 |