| National Provider Identifier [NPI]: | 1396783155 |
| Last Name Of The Provider | LEVEY |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1221 NICOLLET AVE |
| Street Address 2 Of The Provider | SUITE 600 |
| City Of The Provider | MINNEAPOLIS |
| Zip Code Of The Provider | 554032420 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 193 |
| Number Of Services | 6332 |
| Number Of Medicare Beneficiaries | 3197 |
| Total Submitted Charge Amount | 540789.26 |
| Total Medicare Allowed Amount | 187303.61 |
| Total Medicare Payment Amount | 147154.67 |
| Total Medicare Standardized Payment Amount | 149310.84 |
| 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 | 193 |
| Number Of Medical Services | 6332 |
| Number Of Medicare Beneficiaries With Medical Services | 3197 |
| Total Medical Submitted Charge Amount | 540789.26 |
| Total Medical Medicare Allowed Amount | 187303.61 |
| Total Medical Medicare Payment Amount | 147154.67 |
| Total Medical Medicare Standardized Payment Amount | 149310.84 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 592 |
| Number Of Beneficiaries Age 65 to 74 | 1228 |
| Number Of Beneficiaries Age 75 to 84 | 928 |
| Number Of Beneficiaries Age Greater 84 | 449 |
| Number Of Female Beneficiaries | 1880 |
| Number Of Male Beneficiaries | 1317 |
| Number Of Non Hispanic White Beneficiaries | 2814 |
| Number Of Black or African American Beneficiaries | 131 |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| Number Of Hispanic Beneficiaries | 177 |
| Number Of American Indian Alaska Native Beneficiaries | 34 |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2334 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 863 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5333 |