| National Provider Identifier [NPI]: | 1902883481 |
| Last Name Of The Provider | HIMMELSTEIN |
| First Name Of The Provider | STEVAN |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 391 SOUTHCREST CIR |
| Street Address 2 Of The Provider | STE. 200 |
| City Of The Provider | SOUTHAVEN |
| Zip Code Of The Provider | 386714775 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 122 |
| Number Of Services | 10986 |
| Number Of Medicare Beneficiaries | 2853 |
| Total Submitted Charge Amount | 2892742 |
| Total Medicare Allowed Amount | 836088.04 |
| Total Medicare Payment Amount | 635368.95 |
| Total Medicare Standardized Payment Amount | 687364.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 18 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 1013 |
| Total Drug Medicare AllowedAmount | 379.78 |
| Total Drug Medicare PaymentAmount | 335.98 |
| Total Drug Medicare Standardized Payment Amount | 335.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 120 |
| Number Of Medical Services | 10968 |
| Number Of Medicare Beneficiaries With Medical Services | 2853 |
| Total Medical Submitted Charge Amount | 2891729 |
| Total Medical Medicare Allowed Amount | 835708.26 |
| Total Medical Medicare Payment Amount | 635032.97 |
| Total Medical Medicare Standardized Payment Amount | 687028.16 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 482 |
| Number Of Beneficiaries Age 65 to 74 | 1128 |
| Number Of Beneficiaries Age 75 to 84 | 860 |
| Number Of Beneficiaries Age Greater 84 | 383 |
| Number Of Female Beneficiaries | 1448 |
| Number Of Male Beneficiaries | 1405 |
| Number Of Non Hispanic White Beneficiaries | 2273 |
| Number Of Black or African American Beneficiaries | 562 |
| 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 | 2071 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 782 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 72 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5687 |