| National Provider Identifier [NPI]: | 1205840758 |
| Last Name Of The Provider | LAGERGREN |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1713 GARDEN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | TITUSVILLE |
| Zip Code Of The Provider | 327965002 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 3920 |
| Number Of Medicare Beneficiaries | 618 |
| Total Submitted Charge Amount | 363004.88 |
| Total Medicare Allowed Amount | 274414.13 |
| Total Medicare Payment Amount | 192763.35 |
| Total Medicare Standardized Payment Amount | 191468.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 392 |
| Number Of Medicare Beneficiaries With Drug Services | 327 |
| Total Drug Submitted ChargeAmount | 9675.21 |
| Total Drug Medicare AllowedAmount | 6679.98 |
| Total Drug Medicare PaymentAmount | 6323.67 |
| Total Drug Medicare Standardized Payment Amount | 6323.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 3528 |
| Number Of Medicare Beneficiaries With Medical Services | 618 |
| Total Medical Submitted Charge Amount | 353329.67 |
| Total Medical Medicare Allowed Amount | 267734.15 |
| Total Medical Medicare Payment Amount | 186439.68 |
| Total Medical Medicare Standardized Payment Amount | 185144.84 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 223 |
| Number Of Beneficiaries Age 75 to 84 | 262 |
| Number Of Beneficiaries Age Greater 84 | 112 |
| Number Of Female Beneficiaries | 341 |
| Number Of Male Beneficiaries | 277 |
| Number Of Non Hispanic White Beneficiaries | 582 |
| Number Of Black or African American Beneficiaries | 17 |
| 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 | 599 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 19 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2568 |