| National Provider Identifier [NPI]: | 1437161379 |
| Last Name Of The Provider | STEVENS |
| First Name Of The Provider | GREGORY |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1955 E 5600 S |
| Street Address 2 Of The Provider | |
| City Of The Provider | SALT LAKE CITY |
| Zip Code Of The Provider | 841211372 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 4624 |
| Number Of Medicare Beneficiaries | 600 |
| Total Submitted Charge Amount | 345809 |
| Total Medicare Allowed Amount | 231330.01 |
| Total Medicare Payment Amount | 154352.96 |
| Total Medicare Standardized Payment Amount | 163726.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 668 |
| Number Of Medicare Beneficiaries With Drug Services | 199 |
| Total Drug Submitted ChargeAmount | 22521 |
| Total Drug Medicare AllowedAmount | 12872.47 |
| Total Drug Medicare PaymentAmount | 10830.5 |
| Total Drug Medicare Standardized Payment Amount | 10830.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 53 |
| Number Of Medical Services | 3956 |
| Number Of Medicare Beneficiaries With Medical Services | 600 |
| Total Medical Submitted Charge Amount | 323288 |
| Total Medical Medicare Allowed Amount | 218457.54 |
| Total Medical Medicare Payment Amount | 143522.46 |
| Total Medical Medicare Standardized Payment Amount | 152896.43 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 29 |
| Number Of Beneficiaries Age 65 to 74 | 192 |
| Number Of Beneficiaries Age 75 to 84 | 223 |
| Number Of Beneficiaries Age Greater 84 | 156 |
| Number Of Female Beneficiaries | 348 |
| Number Of Male Beneficiaries | 252 |
| Number Of Non Hispanic White Beneficiaries | 578 |
| 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 | 574 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 26 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 5 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1335 |