| National Provider Identifier [NPI]: | 1780658930 |
| Last Name Of The Provider | SHEVITZ |
| First Name Of The Provider | DORIAN |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 900 N AUSTIN AVE |
| Street Address 2 Of The Provider | SUITE 105 |
| City Of The Provider | GEORGETOWN |
| Zip Code Of The Provider | 786264345 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 1072 |
| Number Of Medicare Beneficiaries | 477 |
| Total Submitted Charge Amount | 175504 |
| Total Medicare Allowed Amount | 53673.9 |
| Total Medicare Payment Amount | 38453.95 |
| Total Medicare Standardized Payment Amount | 48260.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 165 |
| Number Of Medicare Beneficiaries With Drug Services | 43 |
| Total Drug Submitted ChargeAmount | 1325 |
| Total Drug Medicare AllowedAmount | 242.15 |
| Total Drug Medicare PaymentAmount | 165.6 |
| Total Drug Medicare Standardized Payment Amount | 165.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 53 |
| Number Of Medical Services | 907 |
| Number Of Medicare Beneficiaries With Medical Services | 477 |
| Total Medical Submitted Charge Amount | 174179 |
| Total Medical Medicare Allowed Amount | 53431.75 |
| Total Medical Medicare Payment Amount | 38288.35 |
| Total Medical Medicare Standardized Payment Amount | 48094.97 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 242 |
| Number Of Beneficiaries Age 75 to 84 | 149 |
| Number Of Beneficiaries Age Greater 84 | 48 |
| Number Of Female Beneficiaries | 314 |
| Number Of Male Beneficiaries | 163 |
| Number Of Non Hispanic White Beneficiaries | 431 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 29 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 440 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 37 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8177 |