| National Provider Identifier [NPI]: | 1477746881 |
| Last Name Of The Provider | CEVASCO |
| First Name Of The Provider | NATHANIEL |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9075 TOWN CENTRE DR |
| Street Address 2 Of The Provider | SUITE 3 |
| City Of The Provider | BROADVIEW HTS |
| Zip Code Of The Provider | 441474044 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 77 |
| Number Of Services | 6581 |
| Number Of Medicare Beneficiaries | 1117 |
| Total Submitted Charge Amount | 815746 |
| Total Medicare Allowed Amount | 489833.81 |
| Total Medicare Payment Amount | 360779.92 |
| Total Medicare Standardized Payment Amount | 370068.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 190 |
| Number Of Medicare Beneficiaries With Drug Services | 100 |
| Total Drug Submitted ChargeAmount | 47660 |
| Total Drug Medicare AllowedAmount | 34150.83 |
| Total Drug Medicare PaymentAmount | 25749.71 |
| Total Drug Medicare Standardized Payment Amount | 25749.71 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 75 |
| Number Of Medical Services | 6391 |
| Number Of Medicare Beneficiaries With Medical Services | 1117 |
| Total Medical Submitted Charge Amount | 768086 |
| Total Medical Medicare Allowed Amount | 455682.98 |
| Total Medical Medicare Payment Amount | 335030.21 |
| Total Medical Medicare Standardized Payment Amount | 344318.41 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 99 |
| Number Of Beneficiaries Age 65 to 74 | 512 |
| Number Of Beneficiaries Age 75 to 84 | 319 |
| Number Of Beneficiaries Age Greater 84 | 187 |
| Number Of Female Beneficiaries | 550 |
| Number Of Male Beneficiaries | 567 |
| Number Of Non Hispanic White Beneficiaries | 1065 |
| Number Of Black or African American Beneficiaries | 15 |
| 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 | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 991 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 126 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0593 |