National Provider Identifier [NPI]: |
1891751673 |
Last Name Of The Provider |
SEVERYN |
First Name Of The Provider |
STEVEN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
410 W 10TH AVE |
Street Address 2 Of The Provider |
N429 DOAN |
City Of The Provider |
COLUMBUS |
Zip Code Of The Provider |
432101240 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
56 |
Number Of Services |
1346 |
Number Of Medicare Beneficiaries |
253 |
Total Submitted Charge Amount |
360547 |
Total Medicare Allowed Amount |
97946.36 |
Total Medicare Payment Amount |
72063.72 |
Total Medicare Standardized Payment Amount |
73522.66 |
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 |
56 |
Number Of Medical Services |
1346 |
Number Of Medicare Beneficiaries With Medical Services |
253 |
Total Medical Submitted Charge Amount |
360547 |
Total Medical Medicare Allowed Amount |
97946.36 |
Total Medical Medicare Payment Amount |
72063.72 |
Total Medical Medicare Standardized Payment Amount |
73522.66 |
Average Age Of Beneficiaries |
60 |
Number Of Beneficiaries Age Less65 |
141 |
Number Of Beneficiaries Age 65 to 74 |
83 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
145 |
Number Of Male Beneficiaries |
108 |
Number Of Non Hispanic White Beneficiaries |
215 |
Number Of Black or African American Beneficiaries |
27 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
154 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
99 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
55 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
70 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.7837 |