| National Provider Identifier [NPI]: | 1538119326 |
| Last Name Of The Provider | ANDERSON |
| First Name Of The Provider | STANLEY |
| 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 | 7072 MEARS GATE DRIVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | NORTH CANTON |
| Zip Code Of The Provider | 447208850 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 1944 |
| Number Of Medicare Beneficiaries | 360 |
| Total Submitted Charge Amount | 130115 |
| Total Medicare Allowed Amount | 101715.64 |
| Total Medicare Payment Amount | 72066.56 |
| Total Medicare Standardized Payment Amount | 74874.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 425 |
| Number Of Medicare Beneficiaries With Drug Services | 92 |
| Total Drug Submitted ChargeAmount | 5440 |
| Total Drug Medicare AllowedAmount | 3796.65 |
| Total Drug Medicare PaymentAmount | 3315.87 |
| Total Drug Medicare Standardized Payment Amount | 3315.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 1519 |
| Number Of Medicare Beneficiaries With Medical Services | 360 |
| Total Medical Submitted Charge Amount | 124675 |
| Total Medical Medicare Allowed Amount | 97918.99 |
| Total Medical Medicare Payment Amount | 68750.69 |
| Total Medical Medicare Standardized Payment Amount | 71558.49 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 29 |
| Number Of Beneficiaries Age 65 to 74 | 216 |
| Number Of Beneficiaries Age 75 to 84 | 79 |
| Number Of Beneficiaries Age Greater 84 | 36 |
| Number Of Female Beneficiaries | 196 |
| Number Of Male Beneficiaries | 164 |
| Number Of Non Hispanic White Beneficiaries | 334 |
| Number Of Black or African American Beneficiaries | |
| 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 | 336 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 24 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8625 |