| National Provider Identifier [NPI]: | 1265671655 |
| Last Name Of The Provider | SEBRO |
| First Name Of The Provider | RONNIE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD, PHD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3737 MARKET ST |
| Street Address 2 Of The Provider | 7TH FLOOR |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191045545 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 142 |
| Number Of Services | 2598 |
| Number Of Medicare Beneficiaries | 1841 |
| Total Submitted Charge Amount | 236047 |
| Total Medicare Allowed Amount | 55197.52 |
| Total Medicare Payment Amount | 41581.43 |
| Total Medicare Standardized Payment Amount | 40598.2 |
| 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 | 142 |
| Number Of Medical Services | 2598 |
| Number Of Medicare Beneficiaries With Medical Services | 1841 |
| Total Medical Submitted Charge Amount | 236047 |
| Total Medical Medicare Allowed Amount | 55197.52 |
| Total Medical Medicare Payment Amount | 41581.43 |
| Total Medical Medicare Standardized Payment Amount | 40598.2 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 295 |
| Number Of Beneficiaries Age 65 to 74 | 705 |
| Number Of Beneficiaries Age 75 to 84 | 563 |
| Number Of Beneficiaries Age Greater 84 | 278 |
| Number Of Female Beneficiaries | 1157 |
| Number Of Male Beneficiaries | 684 |
| Number Of Non Hispanic White Beneficiaries | 1628 |
| Number Of Black or African American Beneficiaries | 51 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 84 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 42 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1377 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 464 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4613 |