| National Provider Identifier [NPI]: | 1730122664 |
| Last Name Of The Provider | LEVIN |
| First Name Of The Provider | FREDRIC |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1314 E APPLE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MUSKEGON |
| Zip Code Of The Provider | 494423759 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 134 |
| Number Of Services | 4275 |
| Number Of Medicare Beneficiaries | 374 |
| Total Submitted Charge Amount | 757768.53 |
| Total Medicare Allowed Amount | 250185.89 |
| Total Medicare Payment Amount | 189541.3 |
| Total Medicare Standardized Payment Amount | 198032.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 2996 |
| Number Of Medicare Beneficiaries With Drug Services | 120 |
| Total Drug Submitted ChargeAmount | 55243.44 |
| Total Drug Medicare AllowedAmount | 36019.07 |
| Total Drug Medicare PaymentAmount | 27858.18 |
| Total Drug Medicare Standardized Payment Amount | 27858.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 127 |
| Number Of Medical Services | 1279 |
| Number Of Medicare Beneficiaries With Medical Services | 374 |
| Total Medical Submitted Charge Amount | 702525.09 |
| Total Medical Medicare Allowed Amount | 214166.82 |
| Total Medical Medicare Payment Amount | 161683.12 |
| Total Medical Medicare Standardized Payment Amount | 170174.18 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 112 |
| Number Of Beneficiaries Age 65 to 74 | 123 |
| Number Of Beneficiaries Age 75 to 84 | 88 |
| Number Of Beneficiaries Age Greater 84 | 51 |
| Number Of Female Beneficiaries | 234 |
| Number Of Male Beneficiaries | 140 |
| Number Of Non Hispanic White Beneficiaries | 332 |
| 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 | 235 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 139 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 68 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2007 |