| National Provider Identifier [NPI]: | 1366421729 |
| Last Name Of The Provider | WARREN |
| First Name Of The Provider | STEVEN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD DPA |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4790 HIDDEN LAKE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | BOUNTIFUL |
| Zip Code Of The Provider | 840106083 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 9 |
| Number Of Services | 2122 |
| Number Of Medicare Beneficiaries | 834 |
| Total Submitted Charge Amount | 190364 |
| Total Medicare Allowed Amount | 164783.05 |
| Total Medicare Payment Amount | 114783.47 |
| Total Medicare Standardized Payment Amount | 118934.74 |
| 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 | 9 |
| Number Of Medical Services | 2122 |
| Number Of Medicare Beneficiaries With Medical Services | 834 |
| Total Medical Submitted Charge Amount | 190364 |
| Total Medical Medicare Allowed Amount | 164783.05 |
| Total Medical Medicare Payment Amount | 114783.47 |
| Total Medical Medicare Standardized Payment Amount | 118934.74 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 197 |
| Number Of Beneficiaries Age 65 to 74 | 223 |
| Number Of Beneficiaries Age 75 to 84 | 200 |
| Number Of Beneficiaries Age Greater 84 | 214 |
| Number Of Female Beneficiaries | 495 |
| Number Of Male Beneficiaries | 339 |
| Number Of Non Hispanic White Beneficiaries | 728 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 23 |
| Number Of Hispanic Beneficiaries | 38 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 231 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 603 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 57 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 48 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 25 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.4849 |