| National Provider Identifier [NPI]: | 1477587368 |
| Last Name Of The Provider | SEVERT |
| First Name Of The Provider | ANTHONY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 701 PARK AVE |
| Street Address 2 Of The Provider | P4 |
| City Of The Provider | MINNEAPOLIS |
| Zip Code Of The Provider | 554151623 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 128 |
| Number Of Services | 3596 |
| Number Of Medicare Beneficiaries | 1917 |
| Total Submitted Charge Amount | 166249 |
| Total Medicare Allowed Amount | 73063.47 |
| Total Medicare Payment Amount | 56124.05 |
| Total Medicare Standardized Payment Amount | 58430.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 128 |
| Number Of Medical Services | 3596 |
| Number Of Medicare Beneficiaries With Medical Services | 1917 |
| Total Medical Submitted Charge Amount | 166249 |
| Total Medical Medicare Allowed Amount | 73063.47 |
| Total Medical Medicare Payment Amount | 56124.05 |
| Total Medical Medicare Standardized Payment Amount | 58430.9 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 1163 |
| Number Of Beneficiaries Age 65 to 74 | 446 |
| Number Of Beneficiaries Age 75 to 84 | 204 |
| Number Of Beneficiaries Age Greater 84 | 104 |
| Number Of Female Beneficiaries | 1061 |
| Number Of Male Beneficiaries | 856 |
| Number Of Non Hispanic White Beneficiaries | 957 |
| Number Of Black or African American Beneficiaries | 762 |
| Number Of AsianPacific Islander Beneficiaries | 46 |
| Number Of Hispanic Beneficiaries | 59 |
| Number Of American Indian Alaska Native Beneficiaries | 55 |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 493 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1424 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 47 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 21 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 2.1119 |