| National Provider Identifier [NPI]: | 1801863550 |
| Last Name Of The Provider | DAHN |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 999 DIVISION ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PRESCOTT |
| Zip Code Of The Provider | 863011654 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 106 |
| Number Of Services | 4280 |
| Number Of Medicare Beneficiaries | 1088 |
| Total Submitted Charge Amount | 577339.75 |
| Total Medicare Allowed Amount | 294608.2 |
| Total Medicare Payment Amount | 221513.42 |
| Total Medicare Standardized Payment Amount | 222923.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 404 |
| Number Of Medicare Beneficiaries With Drug Services | 168 |
| Total Drug Submitted ChargeAmount | 6200 |
| Total Drug Medicare AllowedAmount | 3882.28 |
| Total Drug Medicare PaymentAmount | 3684.73 |
| Total Drug Medicare Standardized Payment Amount | 3684.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 97 |
| Number Of Medical Services | 3876 |
| Number Of Medicare Beneficiaries With Medical Services | 1088 |
| Total Medical Submitted Charge Amount | 571139.75 |
| Total Medical Medicare Allowed Amount | 290725.92 |
| Total Medical Medicare Payment Amount | 217828.69 |
| Total Medical Medicare Standardized Payment Amount | 219238.9 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 58 |
| Number Of Beneficiaries Age 65 to 74 | 363 |
| Number Of Beneficiaries Age 75 to 84 | 389 |
| Number Of Beneficiaries Age Greater 84 | 278 |
| Number Of Female Beneficiaries | 610 |
| Number Of Male Beneficiaries | 478 |
| Number Of Non Hispanic White Beneficiaries | 1036 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 986 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 102 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.2171 |