| National Provider Identifier [NPI]: | 1932269578 |
| Last Name Of The Provider | STEPHENSON |
| First Name Of The Provider | ALLAN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 901 N BROAD ST NE |
| Street Address 2 Of The Provider | SUITE 220 |
| City Of The Provider | ROME |
| Zip Code Of The Provider | 301615207 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 163 |
| Number Of Services | 5196 |
| Number Of Medicare Beneficiaries | 3478 |
| Total Submitted Charge Amount | 733461.65 |
| Total Medicare Allowed Amount | 160941.02 |
| Total Medicare Payment Amount | 122193.36 |
| Total Medicare Standardized Payment Amount | 129088.55 |
| 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 | 163 |
| Number Of Medical Services | 5196 |
| Number Of Medicare Beneficiaries With Medical Services | 3478 |
| Total Medical Submitted Charge Amount | 733461.65 |
| Total Medical Medicare Allowed Amount | 160941.02 |
| Total Medical Medicare Payment Amount | 122193.36 |
| Total Medical Medicare Standardized Payment Amount | 129088.55 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 898 |
| Number Of Beneficiaries Age 65 to 74 | 1320 |
| Number Of Beneficiaries Age 75 to 84 | 884 |
| Number Of Beneficiaries Age Greater 84 | 376 |
| Number Of Female Beneficiaries | 2091 |
| Number Of Male Beneficiaries | 1387 |
| Number Of Non Hispanic White Beneficiaries | 3102 |
| Number Of Black or African American Beneficiaries | 310 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 43 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2372 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1106 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6641 |