| National Provider Identifier [NPI]: | 1528024643 |
| Last Name Of The Provider | LEVINE |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1221 MAIN ST |
| Street Address 2 Of The Provider | SUITE 302 |
| City Of The Provider | HOLYOKE |
| Zip Code Of The Provider | 010405396 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 1149 |
| Number Of Medicare Beneficiaries | 164 |
| Total Submitted Charge Amount | 118717.68 |
| Total Medicare Allowed Amount | 88759.04 |
| Total Medicare Payment Amount | 63899.54 |
| Total Medicare Standardized Payment Amount | 63382.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 64 |
| Number Of Medicare Beneficiaries With Drug Services | 43 |
| Total Drug Submitted ChargeAmount | 1445 |
| Total Drug Medicare AllowedAmount | 770.39 |
| Total Drug Medicare PaymentAmount | 742.86 |
| Total Drug Medicare Standardized Payment Amount | 742.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 1085 |
| Number Of Medicare Beneficiaries With Medical Services | 164 |
| Total Medical Submitted Charge Amount | 117272.68 |
| Total Medical Medicare Allowed Amount | 87988.65 |
| Total Medical Medicare Payment Amount | 63156.68 |
| Total Medical Medicare Standardized Payment Amount | 62639.79 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 54 |
| Number Of Beneficiaries Age 65 to 74 | 38 |
| Number Of Beneficiaries Age 75 to 84 | 33 |
| Number Of Beneficiaries Age Greater 84 | 39 |
| Number Of Female Beneficiaries | 80 |
| Number Of Male Beneficiaries | 84 |
| Number Of Non Hispanic White Beneficiaries | 143 |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 87 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 77 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1458 |