| National Provider Identifier [NPI]: | 1235142316 |
| Last Name Of The Provider | STARK |
| First Name Of The Provider | GEROLD |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3901 PINE LAKE RD |
| Street Address 2 Of The Provider | SUITE 220 |
| City Of The Provider | LINCOLN |
| Zip Code Of The Provider | 685165497 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 113 |
| Number Of Services | 10061 |
| Number Of Medicare Beneficiaries | 491 |
| Total Submitted Charge Amount | 580457 |
| Total Medicare Allowed Amount | 283281.43 |
| Total Medicare Payment Amount | 225891.51 |
| Total Medicare Standardized Payment Amount | 240878.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 381 |
| Number Of Medicare Beneficiaries With Drug Services | 222 |
| Total Drug Submitted ChargeAmount | 12367 |
| Total Drug Medicare AllowedAmount | 7984.52 |
| Total Drug Medicare PaymentAmount | 7556.14 |
| Total Drug Medicare Standardized Payment Amount | 7556.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 102 |
| Number Of Medical Services | 9680 |
| Number Of Medicare Beneficiaries With Medical Services | 491 |
| Total Medical Submitted Charge Amount | 568090 |
| Total Medical Medicare Allowed Amount | 275296.91 |
| Total Medical Medicare Payment Amount | 218335.37 |
| Total Medical Medicare Standardized Payment Amount | 233322.71 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 210 |
| Number Of Beneficiaries Age 75 to 84 | 166 |
| Number Of Beneficiaries Age Greater 84 | 92 |
| Number Of Female Beneficiaries | 257 |
| Number Of Male Beneficiaries | 234 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 452 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 39 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.1481 |