| National Provider Identifier [NPI]: | 1902002744 |
| Last Name Of The Provider | STEPHENS |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12255 DEPAUL DRIVE |
| Street Address 2 Of The Provider | ERNST RADIOLOGY |
| City Of The Provider | BRIDEGTON |
| Zip Code Of The Provider | 63044 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 234 |
| Number Of Services | 6657 |
| Number Of Medicare Beneficiaries | 3993 |
| Total Submitted Charge Amount | 1033171.81 |
| Total Medicare Allowed Amount | 267670.49 |
| Total Medicare Payment Amount | 207753.46 |
| Total Medicare Standardized Payment Amount | 213688.02 |
| 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 | 234 |
| Number Of Medical Services | 6657 |
| Number Of Medicare Beneficiaries With Medical Services | 3993 |
| Total Medical Submitted Charge Amount | 1033171.81 |
| Total Medical Medicare Allowed Amount | 267670.49 |
| Total Medical Medicare Payment Amount | 207753.46 |
| Total Medical Medicare Standardized Payment Amount | 213688.02 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 955 |
| Number Of Beneficiaries Age 65 to 74 | 1368 |
| Number Of Beneficiaries Age 75 to 84 | 1044 |
| Number Of Beneficiaries Age Greater 84 | 626 |
| Number Of Female Beneficiaries | 2436 |
| Number Of Male Beneficiaries | 1557 |
| Number Of Non Hispanic White Beneficiaries | 3072 |
| Number Of Black or African American Beneficiaries | 812 |
| Number Of AsianPacific Islander Beneficiaries | 35 |
| Number Of Hispanic Beneficiaries | 39 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2929 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1064 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.9794 |