| National Provider Identifier [NPI]: | 1508893769 |
| Last Name Of The Provider | LEVINE |
| First Name Of The Provider | DEBRA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 373 AVE X |
| Street Address 2 Of The Provider | |
| City Of The Provider | BROOKLYN |
| Zip Code Of The Provider | 112236003 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 14 |
| Number Of Services | 1370 |
| Number Of Medicare Beneficiaries | 306 |
| Total Submitted Charge Amount | 67732.95 |
| Total Medicare Allowed Amount | 66694.05 |
| Total Medicare Payment Amount | 47879.58 |
| Total Medicare Standardized Payment Amount | 50006.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 1370 |
| Number Of Medicare Beneficiaries With Medical Services | 306 |
| Total Medical Submitted Charge Amount | 67732.95 |
| Total Medical Medicare Allowed Amount | 66694.05 |
| Total Medical Medicare Payment Amount | 47879.58 |
| Total Medical Medicare Standardized Payment Amount | 50006.42 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 20 |
| Number Of Beneficiaries Age 65 to 74 | 95 |
| Number Of Beneficiaries Age 75 to 84 | 104 |
| Number Of Beneficiaries Age Greater 84 | 87 |
| Number Of Female Beneficiaries | 184 |
| Number Of Male Beneficiaries | 122 |
| Number Of Non Hispanic White Beneficiaries | 287 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 258 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 48 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 60 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3509 |