| National Provider Identifier [NPI]: | 1568473494 |
| Last Name Of The Provider | LEVIN |
| First Name Of The Provider | WAYNE |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3690 MAIN STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | BRIDGEPORT |
| Zip Code Of The Provider | 06606 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 2669 |
| Number Of Medicare Beneficiaries | 574 |
| Total Submitted Charge Amount | 224616.5 |
| Total Medicare Allowed Amount | 162147.37 |
| Total Medicare Payment Amount | 120205.02 |
| Total Medicare Standardized Payment Amount | 112505.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 448 |
| Number Of Medicare Beneficiaries With Drug Services | 266 |
| Total Drug Submitted ChargeAmount | 20145 |
| Total Drug Medicare AllowedAmount | 12885.86 |
| Total Drug Medicare PaymentAmount | 12573.34 |
| Total Drug Medicare Standardized Payment Amount | 12573.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 2221 |
| Number Of Medicare Beneficiaries With Medical Services | 574 |
| Total Medical Submitted Charge Amount | 204471.5 |
| Total Medical Medicare Allowed Amount | 149261.51 |
| Total Medical Medicare Payment Amount | 107631.68 |
| Total Medical Medicare Standardized Payment Amount | 99932.15 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 54 |
| Number Of Beneficiaries Age 65 to 74 | 187 |
| Number Of Beneficiaries Age 75 to 84 | 184 |
| Number Of Beneficiaries Age Greater 84 | 149 |
| Number Of Female Beneficiaries | 336 |
| Number Of Male Beneficiaries | 238 |
| Number Of Non Hispanic White Beneficiaries | 421 |
| Number Of Black or African American Beneficiaries | 88 |
| 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 | 367 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 207 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6085 |