| National Provider Identifier [NPI]: | 1891794251 |
| Last Name Of The Provider | LEVINE |
| First Name Of The Provider | STEVEN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 789 AVENUE C |
| Street Address 2 Of The Provider | |
| City Of The Provider | BAYONNE |
| Zip Code Of The Provider | 070022820 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 522 |
| Number Of Medicare Beneficiaries | 154 |
| Total Submitted Charge Amount | 58786 |
| Total Medicare Allowed Amount | 27192.23 |
| Total Medicare Payment Amount | 18863.11 |
| Total Medicare Standardized Payment Amount | 17143.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 36 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 1359 |
| Total Drug Medicare AllowedAmount | 676.23 |
| Total Drug Medicare PaymentAmount | 655.95 |
| Total Drug Medicare Standardized Payment Amount | 655.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 486 |
| Number Of Medicare Beneficiaries With Medical Services | 154 |
| Total Medical Submitted Charge Amount | 57427 |
| Total Medical Medicare Allowed Amount | 26516 |
| Total Medical Medicare Payment Amount | 18207.16 |
| Total Medical Medicare Standardized Payment Amount | 16487.93 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 62 |
| Number Of Beneficiaries Age 75 to 84 | 34 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 84 |
| Number Of Male Beneficiaries | 70 |
| Number Of Non Hispanic White Beneficiaries | 104 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 103 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 51 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 23 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.861 |