| National Provider Identifier [NPI]: | 1164491031 |
| Last Name Of The Provider | EVANGELISTA |
| First Name Of The Provider | GREGORY |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6740 E CAMELBACK RD |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | SCOTTSDALE |
| Zip Code Of The Provider | 852512096 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 117 |
| Number Of Services | 2157 |
| Number Of Medicare Beneficiaries | 419 |
| Total Submitted Charge Amount | 702818.5 |
| Total Medicare Allowed Amount | 233638.64 |
| Total Medicare Payment Amount | 178752.42 |
| Total Medicare Standardized Payment Amount | 181910.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 705 |
| Number Of Medicare Beneficiaries With Drug Services | 155 |
| Total Drug Submitted ChargeAmount | 22431.5 |
| Total Drug Medicare AllowedAmount | 8391.51 |
| Total Drug Medicare PaymentAmount | 6410.36 |
| Total Drug Medicare Standardized Payment Amount | 6410.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 112 |
| Number Of Medical Services | 1452 |
| Number Of Medicare Beneficiaries With Medical Services | 419 |
| Total Medical Submitted Charge Amount | 680387 |
| Total Medical Medicare Allowed Amount | 225247.13 |
| Total Medical Medicare Payment Amount | 172342.06 |
| Total Medical Medicare Standardized Payment Amount | 175499.69 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 204 |
| Number Of Beneficiaries Age 75 to 84 | 119 |
| Number Of Beneficiaries Age Greater 84 | 70 |
| Number Of Female Beneficiaries | 257 |
| Number Of Male Beneficiaries | 162 |
| Number Of Non Hispanic White Beneficiaries | 383 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 383 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 36 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 69 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.5365 |