| National Provider Identifier [NPI]: | 1255464236 |
| Last Name Of The Provider | STAVENS |
| First Name Of The Provider | GERASIMOS |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 MALLARD CREEK RD |
| Street Address 2 Of The Provider | SUITE 150 |
| City Of The Provider | LOUISVILLE |
| Zip Code Of The Provider | 402074194 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 2186 |
| Number Of Medicare Beneficiaries | 754 |
| Total Submitted Charge Amount | 346229.29 |
| Total Medicare Allowed Amount | 163868.57 |
| Total Medicare Payment Amount | 112190.24 |
| Total Medicare Standardized Payment Amount | 121978.06 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 82 |
| Number Of Beneficiaries Age 65 to 74 | 248 |
| Number Of Beneficiaries Age 75 to 84 | 278 |
| Number Of Beneficiaries Age Greater 84 | 146 |
| Number Of Female Beneficiaries | 411 |
| Number Of Male Beneficiaries | 343 |
| Number Of Non Hispanic White Beneficiaries | 672 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 48 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 603 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 151 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5168 |