National Provider Identifier [NPI]: |
1225037336 |
Last Name Of The Provider |
LEVY |
First Name Of The Provider |
LOUIS |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8881 FLETCHER PKWY |
Street Address 2 Of The Provider |
SUITE 250 |
City Of The Provider |
LA MESA |
Zip Code Of The Provider |
919423134 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
54 |
Number Of Services |
1126 |
Number Of Medicare Beneficiaries |
324 |
Total Submitted Charge Amount |
340082 |
Total Medicare Allowed Amount |
151494.86 |
Total Medicare Payment Amount |
112882.75 |
Total Medicare Standardized Payment Amount |
112509.95 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
155 |
Number Of Medicare Beneficiaries With Drug Services |
48 |
Total Drug Submitted ChargeAmount |
10798 |
Total Drug Medicare AllowedAmount |
10514.09 |
Total Drug Medicare PaymentAmount |
8242.93 |
Total Drug Medicare Standardized Payment Amount |
8242.93 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
50 |
Number Of Medical Services |
971 |
Number Of Medicare Beneficiaries With Medical Services |
324 |
Total Medical Submitted Charge Amount |
329284 |
Total Medical Medicare Allowed Amount |
140980.77 |
Total Medical Medicare Payment Amount |
104639.82 |
Total Medical Medicare Standardized Payment Amount |
104267.02 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
46 |
Number Of Beneficiaries Age 65 to 74 |
151 |
Number Of Beneficiaries Age 75 to 84 |
83 |
Number Of Beneficiaries Age Greater 84 |
44 |
Number Of Female Beneficiaries |
200 |
Number Of Male Beneficiaries |
124 |
Number Of Non Hispanic White Beneficiaries |
260 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
33 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
247 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
77 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
72 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2941 |