| 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 |