| National Provider Identifier [NPI]: | 1386672343 |
| Last Name Of The Provider | LEAVITT |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 125 PARKER HILL AVE |
| Street Address 2 Of The Provider | STE 390 |
| City Of The Provider | BOSTON |
| Zip Code Of The Provider | 021202847 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 1954 |
| Number Of Medicare Beneficiaries | 553 |
| Total Submitted Charge Amount | 483228 |
| Total Medicare Allowed Amount | 179302.62 |
| Total Medicare Payment Amount | 137372.45 |
| Total Medicare Standardized Payment Amount | 134055.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 196 |
| Number Of Medicare Beneficiaries With Drug Services | 135 |
| Total Drug Submitted ChargeAmount | 1960 |
| Total Drug Medicare AllowedAmount | 1116.71 |
| Total Drug Medicare PaymentAmount | 855.09 |
| Total Drug Medicare Standardized Payment Amount | 855.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 66 |
| Number Of Medical Services | 1758 |
| Number Of Medicare Beneficiaries With Medical Services | 553 |
| Total Medical Submitted Charge Amount | 481268 |
| Total Medical Medicare Allowed Amount | 178185.91 |
| Total Medical Medicare Payment Amount | 136517.36 |
| Total Medical Medicare Standardized Payment Amount | 133200.79 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 81 |
| Number Of Beneficiaries Age 65 to 74 | 283 |
| Number Of Beneficiaries Age 75 to 84 | 147 |
| Number Of Beneficiaries Age Greater 84 | 42 |
| Number Of Female Beneficiaries | 371 |
| Number Of Male Beneficiaries | 182 |
| Number Of Non Hispanic White Beneficiaries | 494 |
| Number Of Black or African American Beneficiaries | 29 |
| 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 | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 449 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 104 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0699 |