| National Provider Identifier [NPI]: | 1033227640 |
| Last Name Of The Provider | LEVIN |
| First Name Of The Provider | IAN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5455 WILSHIRE BOULEVARD |
| Street Address 2 Of The Provider | SUITE 1120 |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900364201 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 158 |
| Number Of Services | 6853 |
| Number Of Medicare Beneficiaries | 2186 |
| Total Submitted Charge Amount | 738257 |
| Total Medicare Allowed Amount | 196763.25 |
| Total Medicare Payment Amount | 162145.61 |
| Total Medicare Standardized Payment Amount | 149632.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 3191 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 3481 |
| Total Drug Medicare AllowedAmount | 673.16 |
| Total Drug Medicare PaymentAmount | 515.52 |
| Total Drug Medicare Standardized Payment Amount | 515.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 155 |
| Number Of Medical Services | 3662 |
| Number Of Medicare Beneficiaries With Medical Services | 2186 |
| Total Medical Submitted Charge Amount | 734776 |
| Total Medical Medicare Allowed Amount | 196090.09 |
| Total Medical Medicare Payment Amount | 161630.09 |
| Total Medical Medicare Standardized Payment Amount | 149117.43 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 166 |
| Number Of Beneficiaries Age 65 to 74 | 974 |
| Number Of Beneficiaries Age 75 to 84 | 711 |
| Number Of Beneficiaries Age Greater 84 | 335 |
| Number Of Female Beneficiaries | 1618 |
| Number Of Male Beneficiaries | 568 |
| Number Of Non Hispanic White Beneficiaries | 1790 |
| Number Of Black or African American Beneficiaries | 55 |
| Number Of AsianPacific Islander Beneficiaries | 111 |
| Number Of Hispanic Beneficiaries | 189 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1797 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 389 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4989 |