| National Provider Identifier [NPI]: | 1609804111 |
| Last Name Of The Provider | LELEVIER |
| First Name Of The Provider | JON |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD INC |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2067 W VISTA WAY |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | VISTA |
| Zip Code Of The Provider | 920836031 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 77 |
| Number Of Services | 7428 |
| Number Of Medicare Beneficiaries | 413 |
| Total Submitted Charge Amount | 330736.03 |
| Total Medicare Allowed Amount | 327351.25 |
| Total Medicare Payment Amount | 266616.83 |
| Total Medicare Standardized Payment Amount | 258864.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 560 |
| Number Of Medicare Beneficiaries With Drug Services | 320 |
| Total Drug Submitted ChargeAmount | 49293.73 |
| Total Drug Medicare AllowedAmount | 46452.15 |
| Total Drug Medicare PaymentAmount | 45470 |
| Total Drug Medicare Standardized Payment Amount | 45470 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 6868 |
| Number Of Medicare Beneficiaries With Medical Services | 413 |
| Total Medical Submitted Charge Amount | 281442.3 |
| Total Medical Medicare Allowed Amount | 280899.1 |
| Total Medical Medicare Payment Amount | 221146.83 |
| Total Medical Medicare Standardized Payment Amount | 213394.04 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 13 |
| Number Of Beneficiaries Age 65 to 74 | 140 |
| Number Of Beneficiaries Age 75 to 84 | 156 |
| Number Of Beneficiaries Age Greater 84 | 104 |
| Number Of Female Beneficiaries | 229 |
| Number Of Male Beneficiaries | 184 |
| Number Of Non Hispanic White Beneficiaries | 363 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 31 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0993 |