| National Provider Identifier [NPI]: | 1114176674 |
| Last Name Of The Provider | LEVINSOHN |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1899 W MARCH LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | STOCKTON |
| Zip Code Of The Provider | 952076402 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 1960 |
| Number Of Medicare Beneficiaries | 623 |
| Total Submitted Charge Amount | 435477 |
| Total Medicare Allowed Amount | 227774.29 |
| Total Medicare Payment Amount | 160964.8 |
| Total Medicare Standardized Payment Amount | 154570.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 62 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 6000 |
| Total Drug Medicare AllowedAmount | 3951.99 |
| Total Drug Medicare PaymentAmount | 2979.35 |
| Total Drug Medicare Standardized Payment Amount | 2979.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 1898 |
| Number Of Medicare Beneficiaries With Medical Services | 623 |
| Total Medical Submitted Charge Amount | 429477 |
| Total Medical Medicare Allowed Amount | 223822.3 |
| Total Medical Medicare Payment Amount | 157985.45 |
| Total Medical Medicare Standardized Payment Amount | 151590.78 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 129 |
| Number Of Beneficiaries Age 65 to 74 | 268 |
| Number Of Beneficiaries Age 75 to 84 | 165 |
| Number Of Beneficiaries Age Greater 84 | 61 |
| Number Of Female Beneficiaries | 360 |
| Number Of Male Beneficiaries | 263 |
| Number Of Non Hispanic White Beneficiaries | 182 |
| Number Of Black or African American Beneficiaries | 56 |
| Number Of AsianPacific Islander Beneficiaries | 101 |
| Number Of Hispanic Beneficiaries | 263 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 216 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 407 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 55 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3002 |