| National Provider Identifier [NPI]: | 1972723054 |
| Last Name Of The Provider | STEPHENS |
| First Name Of The Provider | JASON |
| 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 | 770 PINE ST STE 290 |
| Street Address 2 Of The Provider | ATTN: RADIOLOGY DEPARTMENT |
| City Of The Provider | MACON |
| Zip Code Of The Provider | 312017516 |
| 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 | 157 |
| Number Of Services | 4817 |
| Number Of Medicare Beneficiaries | 2617 |
| Total Submitted Charge Amount | 787013 |
| Total Medicare Allowed Amount | 173355.63 |
| Total Medicare Payment Amount | 132520.98 |
| Total Medicare Standardized Payment Amount | 141523.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1418 |
| Number Of Medicare Beneficiaries With Drug Services | 54 |
| Total Drug Submitted ChargeAmount | 10541 |
| Total Drug Medicare AllowedAmount | 611.8 |
| Total Drug Medicare PaymentAmount | 479.69 |
| Total Drug Medicare Standardized Payment Amount | 479.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 153 |
| Number Of Medical Services | 3399 |
| Number Of Medicare Beneficiaries With Medical Services | 2617 |
| Total Medical Submitted Charge Amount | 776472 |
| Total Medical Medicare Allowed Amount | 172743.83 |
| Total Medical Medicare Payment Amount | 132041.29 |
| Total Medical Medicare Standardized Payment Amount | 141043.72 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 625 |
| Number Of Beneficiaries Age 65 to 74 | 1001 |
| Number Of Beneficiaries Age 75 to 84 | 692 |
| Number Of Beneficiaries Age Greater 84 | 299 |
| Number Of Female Beneficiaries | 1501 |
| Number Of Male Beneficiaries | 1116 |
| Number Of Non Hispanic White Beneficiaries | 1828 |
| Number Of Black or African American Beneficiaries | 752 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1894 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 723 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.8431 |