| National Provider Identifier [NPI]: | 1013904176 |
| Last Name Of The Provider | SEVERNS |
| First Name Of The Provider | CYRIL |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1500 DODSON AVE |
| Street Address 2 Of The Provider | STE 270 |
| City Of The Provider | FORT SMITH |
| Zip Code Of The Provider | 729015182 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 84 |
| Number Of Services | 7872 |
| Number Of Medicare Beneficiaries | 1273 |
| Total Submitted Charge Amount | 1021736 |
| Total Medicare Allowed Amount | 483656.88 |
| Total Medicare Payment Amount | 346681.63 |
| Total Medicare Standardized Payment Amount | 387329.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 67 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 17585 |
| Total Drug Medicare AllowedAmount | 12376.22 |
| Total Drug Medicare PaymentAmount | 9547.79 |
| Total Drug Medicare Standardized Payment Amount | 9547.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 82 |
| Number Of Medical Services | 7805 |
| Number Of Medicare Beneficiaries With Medical Services | 1273 |
| Total Medical Submitted Charge Amount | 1004151 |
| Total Medical Medicare Allowed Amount | 471280.66 |
| Total Medical Medicare Payment Amount | 337133.84 |
| Total Medical Medicare Standardized Payment Amount | 377782.11 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 110 |
| Number Of Beneficiaries Age 65 to 74 | 538 |
| Number Of Beneficiaries Age 75 to 84 | 439 |
| Number Of Beneficiaries Age Greater 84 | 186 |
| Number Of Female Beneficiaries | 649 |
| Number Of Male Beneficiaries | 624 |
| Number Of Non Hispanic White Beneficiaries | 1203 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 38 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1114 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 159 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1161 |