| National Provider Identifier [NPI]: | 1336274596 |
| Last Name Of The Provider | STUMBO |
| First Name Of The Provider | WARREN |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 566 HIGHWAY 899 |
| Street Address 2 Of The Provider | |
| City Of The Provider | HINDMAN |
| Zip Code Of The Provider | 41822 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 128 |
| Number Of Services | 6461 |
| Number Of Medicare Beneficiaries | 647 |
| Total Submitted Charge Amount | 667118.5 |
| Total Medicare Allowed Amount | 410885.84 |
| Total Medicare Payment Amount | 295372.54 |
| Total Medicare Standardized Payment Amount | 318670.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 700 |
| Number Of Medicare Beneficiaries With Drug Services | 324 |
| Total Drug Submitted ChargeAmount | 35303 |
| Total Drug Medicare AllowedAmount | 15755.27 |
| Total Drug Medicare PaymentAmount | 14901.4 |
| Total Drug Medicare Standardized Payment Amount | 14901.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 112 |
| Number Of Medical Services | 5761 |
| Number Of Medicare Beneficiaries With Medical Services | 647 |
| Total Medical Submitted Charge Amount | 631815.5 |
| Total Medical Medicare Allowed Amount | 395130.57 |
| Total Medical Medicare Payment Amount | 280471.14 |
| Total Medical Medicare Standardized Payment Amount | 303768.83 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 199 |
| Number Of Beneficiaries Age 65 to 74 | 226 |
| Number Of Beneficiaries Age 75 to 84 | 168 |
| Number Of Beneficiaries Age Greater 84 | 54 |
| Number Of Female Beneficiaries | 332 |
| Number Of Male Beneficiaries | 315 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 384 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 263 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3484 |