| National Provider Identifier [NPI]: | 1063478592 |
| Last Name Of The Provider | LEVINE |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 801 E DIXIE AVE |
| Street Address 2 Of The Provider | SUITE 104 |
| City Of The Provider | LEESBURG |
| Zip Code Of The Provider | 347487601 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 158 |
| Number Of Services | 13300 |
| Number Of Medicare Beneficiaries | 2354 |
| Total Submitted Charge Amount | 918909 |
| Total Medicare Allowed Amount | 442326.02 |
| Total Medicare Payment Amount | 360933.8 |
| Total Medicare Standardized Payment Amount | 367923.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 9507 |
| Number Of Medicare Beneficiaries With Drug Services | 166 |
| Total Drug Submitted ChargeAmount | 27470 |
| Total Drug Medicare AllowedAmount | 3924.92 |
| Total Drug Medicare PaymentAmount | 3060.07 |
| Total Drug Medicare Standardized Payment Amount | 3060.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 151 |
| Number Of Medical Services | 3793 |
| Number Of Medicare Beneficiaries With Medical Services | 2349 |
| Total Medical Submitted Charge Amount | 891439 |
| Total Medical Medicare Allowed Amount | 438401.1 |
| Total Medical Medicare Payment Amount | 357873.73 |
| Total Medical Medicare Standardized Payment Amount | 364863.64 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 85 |
| Number Of Beneficiaries Age 65 to 74 | 1174 |
| Number Of Beneficiaries Age 75 to 84 | 882 |
| Number Of Beneficiaries Age Greater 84 | 213 |
| Number Of Female Beneficiaries | 1735 |
| Number Of Male Beneficiaries | 619 |
| Number Of Non Hispanic White Beneficiaries | 2259 |
| Number Of Black or African American Beneficiaries | 31 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 34 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2275 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 79 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.17 |