| National Provider Identifier [NPI]: | 1093748600 |
| Last Name Of The Provider | SEVERINO |
| First Name Of The Provider | OLIVER |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2060 W 24TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | YUMA |
| Zip Code Of The Provider | 853646123 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 586 |
| Number Of Medicare Beneficiaries | 247 |
| Total Submitted Charge Amount | 19082 |
| Total Medicare Allowed Amount | 8355.34 |
| Total Medicare Payment Amount | 7731.82 |
| Total Medicare Standardized Payment Amount | 7767.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 132 |
| Number Of Medicare Beneficiaries With Drug Services | 124 |
| Total Drug Submitted ChargeAmount | 4412 |
| Total Drug Medicare AllowedAmount | 2333.1 |
| Total Drug Medicare PaymentAmount | 2285.32 |
| Total Drug Medicare Standardized Payment Amount | 2285.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 454 |
| Number Of Medicare Beneficiaries With Medical Services | 244 |
| Total Medical Submitted Charge Amount | 14670 |
| Total Medical Medicare Allowed Amount | 6022.24 |
| Total Medical Medicare Payment Amount | 5446.5 |
| Total Medical Medicare Standardized Payment Amount | 5482.07 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 141 |
| Number Of Beneficiaries Age 75 to 84 | 53 |
| Number Of Beneficiaries Age Greater 84 | 14 |
| Number Of Female Beneficiaries | 115 |
| Number Of Male Beneficiaries | 132 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 236 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 81 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 166 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 4 |
| Percent Of With Depression | 6 |
| Percent Of With Diabetes | 62 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 22 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1188 |