| National Provider Identifier [NPI]: | 1619913472 |
| Last Name Of The Provider | STEFANEK |
| First Name Of The Provider | GREGG |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1910 PINE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ALMA |
| Zip Code Of The Provider | 488011298 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 84 |
| Number Of Services | 1681 |
| Number Of Medicare Beneficiaries | 490 |
| Total Submitted Charge Amount | 151161 |
| Total Medicare Allowed Amount | 104744.69 |
| Total Medicare Payment Amount | 77107.32 |
| Total Medicare Standardized Payment Amount | 80550.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 255 |
| Number Of Medicare Beneficiaries With Drug Services | 180 |
| Total Drug Submitted ChargeAmount | 7407 |
| Total Drug Medicare AllowedAmount | 5885.44 |
| Total Drug Medicare PaymentAmount | 5683.58 |
| Total Drug Medicare Standardized Payment Amount | 5683.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 75 |
| Number Of Medical Services | 1426 |
| Number Of Medicare Beneficiaries With Medical Services | 490 |
| Total Medical Submitted Charge Amount | 143754 |
| Total Medical Medicare Allowed Amount | 98859.25 |
| Total Medical Medicare Payment Amount | 71423.74 |
| Total Medical Medicare Standardized Payment Amount | 74867.38 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 49 |
| Number Of Beneficiaries Age 65 to 74 | 233 |
| Number Of Beneficiaries Age 75 to 84 | 139 |
| Number Of Beneficiaries Age Greater 84 | 69 |
| Number Of Female Beneficiaries | 251 |
| Number Of Male Beneficiaries | 239 |
| Number Of Non Hispanic White Beneficiaries | 474 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 431 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 59 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0196 |