| National Provider Identifier [NPI]: | 1215926274 |
| Last Name Of The Provider | COLVIN |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1125 E SOUTHERN AVE |
| Street Address 2 Of The Provider | STE 300 |
| City Of The Provider | MESA |
| Zip Code Of The Provider | 852045045 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 178 |
| Number Of Services | 7403 |
| Number Of Medicare Beneficiaries | 2839 |
| Total Submitted Charge Amount | 645144 |
| Total Medicare Allowed Amount | 178877.26 |
| Total Medicare Payment Amount | 129608.01 |
| Total Medicare Standardized Payment Amount | 133315.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1625 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 2680 |
| Total Drug Medicare AllowedAmount | 344.88 |
| Total Drug Medicare PaymentAmount | 270.35 |
| Total Drug Medicare Standardized Payment Amount | 270.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 176 |
| Number Of Medical Services | 5778 |
| Number Of Medicare Beneficiaries With Medical Services | 2839 |
| Total Medical Submitted Charge Amount | 642464 |
| Total Medical Medicare Allowed Amount | 178532.38 |
| Total Medical Medicare Payment Amount | 129337.66 |
| Total Medical Medicare Standardized Payment Amount | 133044.84 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 436 |
| Number Of Beneficiaries Age 65 to 74 | 1138 |
| Number Of Beneficiaries Age 75 to 84 | 872 |
| Number Of Beneficiaries Age Greater 84 | 393 |
| Number Of Female Beneficiaries | 1445 |
| Number Of Male Beneficiaries | 1394 |
| Number Of Non Hispanic White Beneficiaries | 2349 |
| Number Of Black or African American Beneficiaries | 109 |
| Number Of AsianPacific Islander Beneficiaries | 32 |
| Number Of Hispanic Beneficiaries | 207 |
| Number Of American Indian Alaska Native Beneficiaries | 116 |
| Number Of Beneficiaries With Race Not Else where Classified | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2259 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 580 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.6342 |