| National Provider Identifier [NPI]: | 1649255241 |
| Last Name Of The Provider | STEVENSON |
| First Name Of The Provider | JON |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2075 W PECOS RD |
| Street Address 2 Of The Provider | STE 1 |
| City Of The Provider | CHANDLER |
| Zip Code Of The Provider | 85224 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 85 |
| Number Of Services | 7847 |
| Number Of Medicare Beneficiaries | 1911 |
| Total Submitted Charge Amount | 1377264.95 |
| Total Medicare Allowed Amount | 789450.6 |
| Total Medicare Payment Amount | 592449.56 |
| Total Medicare Standardized Payment Amount | 595623.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 644 |
| Number Of Medicare Beneficiaries With Drug Services | 161 |
| Total Drug Submitted ChargeAmount | 48300 |
| Total Drug Medicare AllowedAmount | 34106.77 |
| Total Drug Medicare PaymentAmount | 26739.5 |
| Total Drug Medicare Standardized Payment Amount | 26739.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 84 |
| Number Of Medical Services | 7203 |
| Number Of Medicare Beneficiaries With Medical Services | 1911 |
| Total Medical Submitted Charge Amount | 1328964.95 |
| Total Medical Medicare Allowed Amount | 755343.83 |
| Total Medical Medicare Payment Amount | 565710.06 |
| Total Medical Medicare Standardized Payment Amount | 568883.83 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 76 |
| Number Of Beneficiaries Age 65 to 74 | 926 |
| Number Of Beneficiaries Age 75 to 84 | 653 |
| Number Of Beneficiaries Age Greater 84 | 256 |
| Number Of Female Beneficiaries | 966 |
| Number Of Male Beneficiaries | 945 |
| Number Of Non Hispanic White Beneficiaries | 1710 |
| Number Of Black or African American Beneficiaries | 56 |
| Number Of AsianPacific Islander Beneficiaries | 24 |
| Number Of Hispanic Beneficiaries | 76 |
| Number Of American Indian Alaska Native Beneficiaries | 14 |
| Number Of Beneficiaries With Race Not Else where Classified | 31 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1855 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 56 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.251 |