| National Provider Identifier [NPI]: | 1255421442 |
| Last Name Of The Provider | RAVITZ |
| First Name Of The Provider | MARJORIE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 260 MIDDLE COUNTRY ROAD |
| Street Address 2 Of The Provider | STE 104 |
| City Of The Provider | SMITHTOWN |
| Zip Code Of The Provider | 11787 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 3918 |
| Number Of Medicare Beneficiaries | 957 |
| Total Submitted Charge Amount | 395651.5 |
| Total Medicare Allowed Amount | 347942.45 |
| Total Medicare Payment Amount | 248996.71 |
| Total Medicare Standardized Payment Amount | 216773.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 92 |
| Number Of Medicare Beneficiaries With Drug Services | 68 |
| Total Drug Submitted ChargeAmount | 920 |
| Total Drug Medicare AllowedAmount | 519.29 |
| Total Drug Medicare PaymentAmount | 407.19 |
| Total Drug Medicare Standardized Payment Amount | 407.19 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 3826 |
| Number Of Medicare Beneficiaries With Medical Services | 957 |
| Total Medical Submitted Charge Amount | 394731.5 |
| Total Medical Medicare Allowed Amount | 347423.16 |
| Total Medical Medicare Payment Amount | 248589.52 |
| Total Medical Medicare Standardized Payment Amount | 216366.69 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 66 |
| Number Of Beneficiaries Age 65 to 74 | 463 |
| Number Of Beneficiaries Age 75 to 84 | 321 |
| Number Of Beneficiaries Age Greater 84 | 107 |
| Number Of Female Beneficiaries | 600 |
| Number Of Male Beneficiaries | 357 |
| Number Of Non Hispanic White Beneficiaries | 907 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 907 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 50 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.206 |