| National Provider Identifier [NPI]: | 1407858137 |
| Last Name Of The Provider | STEPHENS |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 322 BEARD CREEK RD |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | EDWARDS |
| Zip Code Of The Provider | 816326426 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 83 |
| Number Of Services | 2763 |
| Number Of Medicare Beneficiaries | 398 |
| Total Submitted Charge Amount | 277709 |
| Total Medicare Allowed Amount | 136553.28 |
| Total Medicare Payment Amount | 106230.43 |
| Total Medicare Standardized Payment Amount | 107327.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 139 |
| Number Of Medicare Beneficiaries With Drug Services | 101 |
| Total Drug Submitted ChargeAmount | 10736 |
| Total Drug Medicare AllowedAmount | 9553.79 |
| Total Drug Medicare PaymentAmount | 9167.48 |
| Total Drug Medicare Standardized Payment Amount | 9167.48 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 2624 |
| Number Of Medicare Beneficiaries With Medical Services | 398 |
| Total Medical Submitted Charge Amount | 266973 |
| Total Medical Medicare Allowed Amount | 126999.49 |
| Total Medical Medicare Payment Amount | 97062.95 |
| Total Medical Medicare Standardized Payment Amount | 98159.64 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 255 |
| Number Of Beneficiaries Age 75 to 84 | 112 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 130 |
| Number Of Male Beneficiaries | 268 |
| Number Of Non Hispanic White Beneficiaries | 359 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 9 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 5 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 15 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 45 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7183 |