National Provider Identifier [NPI]: |
1336124254 |
Last Name Of The Provider |
LEVIN |
First Name Of The Provider |
GARY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4150 V ST |
Street Address 2 Of The Provider |
PSSB-SUITE 1200, MED: ANESTHESIA |
City Of The Provider |
SACRAMENTO |
Zip Code Of The Provider |
958171460 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
55 |
Number Of Services |
188 |
Number Of Medicare Beneficiaries |
153 |
Total Submitted Charge Amount |
385675 |
Total Medicare Allowed Amount |
44972.64 |
Total Medicare Payment Amount |
35254.59 |
Total Medicare Standardized Payment Amount |
35101.91 |
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 |
55 |
Number Of Medical Services |
188 |
Number Of Medicare Beneficiaries With Medical Services |
153 |
Total Medical Submitted Charge Amount |
385675 |
Total Medical Medicare Allowed Amount |
44972.64 |
Total Medical Medicare Payment Amount |
35254.59 |
Total Medical Medicare Standardized Payment Amount |
35101.91 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
53 |
Number Of Beneficiaries Age 65 to 74 |
56 |
Number Of Beneficiaries Age 75 to 84 |
31 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
85 |
Number Of Male Beneficiaries |
68 |
Number Of Non Hispanic White Beneficiaries |
105 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
17 |
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
81 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
72 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.9277 |