| National Provider Identifier [NPI]: | 1871534057 |
| Last Name Of The Provider | JEPSEN |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4439 STATE ROUTE 159 |
| Street Address 2 Of The Provider | SUITE 130 |
| City Of The Provider | CHILLICOTHE |
| Zip Code Of The Provider | 456018207 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Vascular Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 104 |
| Number Of Services | 1626 |
| Number Of Medicare Beneficiaries | 870 |
| Total Submitted Charge Amount | 476874 |
| Total Medicare Allowed Amount | 164529 |
| Total Medicare Payment Amount | 126257.64 |
| Total Medicare Standardized Payment Amount | 125047.84 |
| 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 | 104 |
| Number Of Medical Services | 1626 |
| Number Of Medicare Beneficiaries With Medical Services | 870 |
| Total Medical Submitted Charge Amount | 476874 |
| Total Medical Medicare Allowed Amount | 164529 |
| Total Medical Medicare Payment Amount | 126257.64 |
| Total Medical Medicare Standardized Payment Amount | 125047.84 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 214 |
| Number Of Beneficiaries Age 65 to 74 | 324 |
| Number Of Beneficiaries Age 75 to 84 | 246 |
| Number Of Beneficiaries Age Greater 84 | 86 |
| Number Of Female Beneficiaries | 491 |
| Number Of Male Beneficiaries | 379 |
| Number Of Non Hispanic White Beneficiaries | 841 |
| Number Of Black or African American Beneficiaries | 17 |
| 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 | 530 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 340 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 43 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.8433 |