| National Provider Identifier [NPI]: | 1871543660 |
| Last Name Of The Provider | STEPHANIAN |
| First Name Of The Provider | EDIC |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 700 WALTER REED BLVD |
| Street Address 2 Of The Provider | SUITE 203 |
| City Of The Provider | GARLAND |
| Zip Code Of The Provider | 750423701 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Vascular Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 157 |
| Number Of Services | 7188 |
| Number Of Medicare Beneficiaries | 1683 |
| Total Submitted Charge Amount | 11650426.89 |
| Total Medicare Allowed Amount | 3127414.41 |
| Total Medicare Payment Amount | 2378317.91 |
| Total Medicare Standardized Payment Amount | 2422073.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 1705 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 13640 |
| Total Drug Medicare AllowedAmount | 290.62 |
| Total Drug Medicare PaymentAmount | 227.8 |
| Total Drug Medicare Standardized Payment Amount | 227.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 156 |
| Number Of Medical Services | 5483 |
| Number Of Medicare Beneficiaries With Medical Services | 1683 |
| Total Medical Submitted Charge Amount | 11636786.89 |
| Total Medical Medicare Allowed Amount | 3127123.79 |
| Total Medical Medicare Payment Amount | 2378090.11 |
| Total Medical Medicare Standardized Payment Amount | 2421846.07 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 255 |
| Number Of Beneficiaries Age 65 to 74 | 653 |
| Number Of Beneficiaries Age 75 to 84 | 534 |
| Number Of Beneficiaries Age Greater 84 | 241 |
| Number Of Female Beneficiaries | 914 |
| Number Of Male Beneficiaries | 769 |
| Number Of Non Hispanic White Beneficiaries | 1265 |
| Number Of Black or African American Beneficiaries | 179 |
| Number Of AsianPacific Islander Beneficiaries | 79 |
| Number Of Hispanic Beneficiaries | 148 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1306 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 377 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.2295 |