| National Provider Identifier [NPI]: | 1538162946 |
| Last Name Of The Provider | SELVIDGE |
| First Name Of The Provider | SIDNEY |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7695 POPLAR PIKE |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | GERMANTOWN |
| Zip Code Of The Provider | 381385947 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 135 |
| Number Of Services | 5389 |
| Number Of Medicare Beneficiaries | 3676 |
| Total Submitted Charge Amount | 1070542 |
| Total Medicare Allowed Amount | 202722.57 |
| Total Medicare Payment Amount | 155784.87 |
| Total Medicare Standardized Payment Amount | 166713.4 |
| 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 | 135 |
| Number Of Medical Services | 5389 |
| Number Of Medicare Beneficiaries With Medical Services | 3676 |
| Total Medical Submitted Charge Amount | 1070542 |
| Total Medical Medicare Allowed Amount | 202722.57 |
| Total Medical Medicare Payment Amount | 155784.87 |
| Total Medical Medicare Standardized Payment Amount | 166713.4 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 1022 |
| Number Of Beneficiaries Age 65 to 74 | 1223 |
| Number Of Beneficiaries Age 75 to 84 | 951 |
| Number Of Beneficiaries Age Greater 84 | 480 |
| Number Of Female Beneficiaries | 2139 |
| Number Of Male Beneficiaries | 1537 |
| Number Of Non Hispanic White Beneficiaries | 1861 |
| Number Of Black or African American Beneficiaries | 1757 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2274 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1402 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 20 |
| Average HCC Risk Score Of Beneficiaries | 2.3201 |