| National Provider Identifier [NPI]: | 1023055472 |
| Last Name Of The Provider | SELVA |
| First Name Of The Provider | SERGIO |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 512 NOKOMIS AVE S |
| Street Address 2 Of The Provider | |
| City Of The Provider | VENICE |
| Zip Code Of The Provider | 342852817 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 264 |
| Number Of Services | 25334.5 |
| Number Of Medicare Beneficiaries | 5098 |
| Total Submitted Charge Amount | 518485.63 |
| Total Medicare Allowed Amount | 427668.17 |
| Total Medicare Payment Amount | 334153.91 |
| Total Medicare Standardized Payment Amount | 341660.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 15410.5 |
| Number Of Medicare Beneficiaries With Drug Services | 167 |
| Total Drug Submitted ChargeAmount | 8052.63 |
| Total Drug Medicare AllowedAmount | 3700.92 |
| Total Drug Medicare PaymentAmount | 2891.72 |
| Total Drug Medicare Standardized Payment Amount | 2891.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 252 |
| Number Of Medical Services | 9924 |
| Number Of Medicare Beneficiaries With Medical Services | 5098 |
| Total Medical Submitted Charge Amount | 510433 |
| Total Medical Medicare Allowed Amount | 423967.25 |
| Total Medical Medicare Payment Amount | 331262.19 |
| Total Medical Medicare Standardized Payment Amount | 338769.07 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 276 |
| Number Of Beneficiaries Age 65 to 74 | 1728 |
| Number Of Beneficiaries Age 75 to 84 | 1815 |
| Number Of Beneficiaries Age Greater 84 | 1279 |
| Number Of Female Beneficiaries | 2860 |
| Number Of Male Beneficiaries | 2238 |
| Number Of Non Hispanic White Beneficiaries | 4948 |
| Number Of Black or African American Beneficiaries | 32 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 45 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 54 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4652 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 446 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5178 |