| National Provider Identifier [NPI]: | 1295707362 |
| Last Name Of The Provider | DEAN |
| First Name Of The Provider | SHERVIN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4518 UNION DEPOSIT RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | HARRISBURG |
| Zip Code Of The Provider | 17111 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 171 |
| Number Of Services | 4434 |
| Number Of Medicare Beneficiaries | 2170 |
| Total Submitted Charge Amount | 611557.3 |
| Total Medicare Allowed Amount | 119169.07 |
| Total Medicare Payment Amount | 89895.1 |
| Total Medicare Standardized Payment Amount | 93937.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1205 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 4159.3 |
| Total Drug Medicare AllowedAmount | 422.03 |
| Total Drug Medicare PaymentAmount | 307.69 |
| Total Drug Medicare Standardized Payment Amount | 307.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 169 |
| Number Of Medical Services | 3229 |
| Number Of Medicare Beneficiaries With Medical Services | 2170 |
| Total Medical Submitted Charge Amount | 607398 |
| Total Medical Medicare Allowed Amount | 118747.04 |
| Total Medical Medicare Payment Amount | 89587.41 |
| Total Medical Medicare Standardized Payment Amount | 93629.82 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 341 |
| Number Of Beneficiaries Age 65 to 74 | 991 |
| Number Of Beneficiaries Age 75 to 84 | 582 |
| Number Of Beneficiaries Age Greater 84 | 256 |
| Number Of Female Beneficiaries | 1473 |
| Number Of Male Beneficiaries | 697 |
| Number Of Non Hispanic White Beneficiaries | 1971 |
| Number Of Black or African American Beneficiaries | 115 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 40 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1833 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 337 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2934 |