| National Provider Identifier [NPI]: | 1053316562 |
| Last Name Of The Provider | IRVIN |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1050 JABARRAH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SEYMOUR JOHNSON A F B |
| Zip Code Of The Provider | 275312310 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 1482 |
| Number Of Medicare Beneficiaries | 498 |
| Total Submitted Charge Amount | 303323 |
| Total Medicare Allowed Amount | 120850.66 |
| Total Medicare Payment Amount | 93801.58 |
| Total Medicare Standardized Payment Amount | 97164.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 1482 |
| Number Of Medicare Beneficiaries With Medical Services | 498 |
| Total Medical Submitted Charge Amount | 303323 |
| Total Medical Medicare Allowed Amount | 120850.66 |
| Total Medical Medicare Payment Amount | 93801.58 |
| Total Medical Medicare Standardized Payment Amount | 97164.78 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 83 |
| Number Of Beneficiaries Age 65 to 74 | 149 |
| Number Of Beneficiaries Age 75 to 84 | 152 |
| Number Of Beneficiaries Age Greater 84 | 114 |
| Number Of Female Beneficiaries | 274 |
| Number Of Male Beneficiaries | 224 |
| Number Of Non Hispanic White Beneficiaries | 374 |
| Number Of Black or African American Beneficiaries | 111 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 339 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 159 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 31 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 51 |
| Percent Of With Chronic Kidney Disease | 65 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 49 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 56 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.5559 |