| National Provider Identifier [NPI]: | 1710075536 |
| Last Name Of The Provider | LEVIN |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 770 MASON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | VACAVILLE |
| Zip Code Of The Provider | 956884646 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 100 |
| Number Of Services | 6356 |
| Number Of Medicare Beneficiaries | 787 |
| Total Submitted Charge Amount | 2206901.4 |
| Total Medicare Allowed Amount | 537489.25 |
| Total Medicare Payment Amount | 400602.39 |
| Total Medicare Standardized Payment Amount | 360419.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 3109 |
| Number Of Medicare Beneficiaries With Drug Services | 150 |
| Total Drug Submitted ChargeAmount | 298218 |
| Total Drug Medicare AllowedAmount | 97659.97 |
| Total Drug Medicare PaymentAmount | 76361.24 |
| Total Drug Medicare Standardized Payment Amount | 76361.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 86 |
| Number Of Medical Services | 3247 |
| Number Of Medicare Beneficiaries With Medical Services | 787 |
| Total Medical Submitted Charge Amount | 1908683.4 |
| Total Medical Medicare Allowed Amount | 439829.28 |
| Total Medical Medicare Payment Amount | 324241.15 |
| Total Medical Medicare Standardized Payment Amount | 284058.03 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 334 |
| Number Of Beneficiaries Age 75 to 84 | 284 |
| Number Of Beneficiaries Age Greater 84 | 118 |
| Number Of Female Beneficiaries | 213 |
| Number Of Male Beneficiaries | 574 |
| Number Of Non Hispanic White Beneficiaries | 580 |
| Number Of Black or African American Beneficiaries | 80 |
| Number Of AsianPacific Islander Beneficiaries | 44 |
| Number Of Hispanic Beneficiaries | 61 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 752 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 35 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 25 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1994 |