| National Provider Identifier [NPI]: | 1760534655 |
| Last Name Of The Provider | LEVIN |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 435 SCRANTON CARBONDALE HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | SCRANTON |
| Zip Code Of The Provider | 185081115 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 81 |
| Number Of Services | 3597 |
| Number Of Medicare Beneficiaries | 2128 |
| Total Submitted Charge Amount | 588594 |
| Total Medicare Allowed Amount | 265813.84 |
| Total Medicare Payment Amount | 212080.67 |
| Total Medicare Standardized Payment Amount | 229509.92 |
| 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 | 81 |
| Number Of Medical Services | 3597 |
| Number Of Medicare Beneficiaries With Medical Services | 2128 |
| Total Medical Submitted Charge Amount | 588594 |
| Total Medical Medicare Allowed Amount | 265813.84 |
| Total Medical Medicare Payment Amount | 212080.67 |
| Total Medical Medicare Standardized Payment Amount | 229509.92 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 304 |
| Number Of Beneficiaries Age 65 to 74 | 1040 |
| Number Of Beneficiaries Age 75 to 84 | 602 |
| Number Of Beneficiaries Age Greater 84 | 182 |
| Number Of Female Beneficiaries | 1533 |
| Number Of Male Beneficiaries | 595 |
| Number Of Non Hispanic White Beneficiaries | 2062 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 29 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1812 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 316 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0778 |