| National Provider Identifier [NPI]: | 1275577793 |
| Last Name Of The Provider | LEVEQUE |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1303 E HERNDON AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | FRESNO |
| Zip Code Of The Provider | 937203309 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 2882 |
| Number Of Medicare Beneficiaries | 1524 |
| Total Submitted Charge Amount | 1122458 |
| Total Medicare Allowed Amount | 298358.87 |
| Total Medicare Payment Amount | 232516.87 |
| Total Medicare Standardized Payment Amount | 229620.14 |
| 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 | 50 |
| Number Of Medical Services | 2882 |
| Number Of Medicare Beneficiaries With Medical Services | 1524 |
| Total Medical Submitted Charge Amount | 1122458 |
| Total Medical Medicare Allowed Amount | 298358.87 |
| Total Medical Medicare Payment Amount | 232516.87 |
| Total Medical Medicare Standardized Payment Amount | 229620.14 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 273 |
| Number Of Beneficiaries Age 65 to 74 | 420 |
| Number Of Beneficiaries Age 75 to 84 | 412 |
| Number Of Beneficiaries Age Greater 84 | 419 |
| Number Of Female Beneficiaries | 910 |
| Number Of Male Beneficiaries | 614 |
| Number Of Non Hispanic White Beneficiaries | 951 |
| Number Of Black or African American Beneficiaries | 93 |
| Number Of AsianPacific Islander Beneficiaries | 104 |
| Number Of Hispanic Beneficiaries | 339 |
| Number Of American Indian Alaska Native Beneficiaries | 21 |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 797 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 727 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 30 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.3218 |