National Provider Identifier [NPI]: |
1326082975 |
Last Name Of The Provider |
SEVIGNY |
First Name Of The Provider |
STEPHEN |
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 |
1673 MASON AVE |
Street Address 2 Of The Provider |
SUITE# 305 |
City Of The Provider |
DAYTONA BEACH |
Zip Code Of The Provider |
321175515 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
198 |
Number Of Services |
25982.5 |
Number Of Medicare Beneficiaries |
3629 |
Total Submitted Charge Amount |
2986008.04 |
Total Medicare Allowed Amount |
789526.91 |
Total Medicare Payment Amount |
603742.37 |
Total Medicare Standardized Payment Amount |
621954.68 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
20756.5 |
Number Of Medicare Beneficiaries With Drug Services |
390 |
Total Drug Submitted ChargeAmount |
32240.36 |
Total Drug Medicare AllowedAmount |
7048.55 |
Total Drug Medicare PaymentAmount |
5476.49 |
Total Drug Medicare Standardized Payment Amount |
5476.49 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
188 |
Number Of Medical Services |
5226 |
Number Of Medicare Beneficiaries With Medical Services |
3628 |
Total Medical Submitted Charge Amount |
2953767.68 |
Total Medical Medicare Allowed Amount |
782478.36 |
Total Medical Medicare Payment Amount |
598265.88 |
Total Medical Medicare Standardized Payment Amount |
616478.19 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
502 |
Number Of Beneficiaries Age 65 to 74 |
1650 |
Number Of Beneficiaries Age 75 to 84 |
1072 |
Number Of Beneficiaries Age Greater 84 |
405 |
Number Of Female Beneficiaries |
2322 |
Number Of Male Beneficiaries |
1307 |
Number Of Non Hispanic White Beneficiaries |
3170 |
Number Of Black or African American Beneficiaries |
269 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
118 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
42 |
Number Of Beneficiaries With Medicare Only Entitlement |
3061 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
568 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2808 |