| National Provider Identifier [NPI]: | 1437191749 |
| Last Name Of The Provider | SELZER |
| First Name Of The Provider | JERROLD |
| 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 | 3739 HIXSON PIKE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHATTANOOGA |
| Zip Code Of The Provider | 374153520 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 83 |
| Number Of Services | 8325 |
| Number Of Medicare Beneficiaries | 769 |
| Total Submitted Charge Amount | 541266 |
| Total Medicare Allowed Amount | 213175.63 |
| Total Medicare Payment Amount | 175257.73 |
| Total Medicare Standardized Payment Amount | 185407.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 233 |
| Number Of Medicare Beneficiaries With Drug Services | 188 |
| Total Drug Submitted ChargeAmount | 13334 |
| Total Drug Medicare AllowedAmount | 7625.02 |
| Total Drug Medicare PaymentAmount | 7362.54 |
| Total Drug Medicare Standardized Payment Amount | 7362.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 73 |
| Number Of Medical Services | 8092 |
| Number Of Medicare Beneficiaries With Medical Services | 769 |
| Total Medical Submitted Charge Amount | 527932 |
| Total Medical Medicare Allowed Amount | 205550.61 |
| Total Medical Medicare Payment Amount | 167895.19 |
| Total Medical Medicare Standardized Payment Amount | 178044.81 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 58 |
| Number Of Beneficiaries Age 65 to 74 | 377 |
| Number Of Beneficiaries Age 75 to 84 | 234 |
| Number Of Beneficiaries Age Greater 84 | 100 |
| Number Of Female Beneficiaries | 408 |
| Number Of Male Beneficiaries | 361 |
| Number Of Non Hispanic White Beneficiaries | 738 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 705 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 64 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 2 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9638 |