| National Provider Identifier [NPI]: | 1720269137 |
| Last Name Of The Provider | STEPHENSON |
| First Name Of The Provider | JASON |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 600 HIGHLAND AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MADISON |
| Zip Code Of The Provider | 537920001 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 118 |
| Number Of Services | 2195 |
| Number Of Medicare Beneficiaries | 1456 |
| Total Submitted Charge Amount | 419365 |
| Total Medicare Allowed Amount | 51104.58 |
| Total Medicare Payment Amount | 37979.22 |
| Total Medicare Standardized Payment Amount | 39446.21 |
| 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 | 118 |
| Number Of Medical Services | 2195 |
| Number Of Medicare Beneficiaries With Medical Services | 1456 |
| Total Medical Submitted Charge Amount | 419365 |
| Total Medical Medicare Allowed Amount | 51104.58 |
| Total Medical Medicare Payment Amount | 37979.22 |
| Total Medical Medicare Standardized Payment Amount | 39446.21 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 332 |
| Number Of Beneficiaries Age 65 to 74 | 601 |
| Number Of Beneficiaries Age 75 to 84 | 356 |
| Number Of Beneficiaries Age Greater 84 | 167 |
| Number Of Female Beneficiaries | 874 |
| Number Of Male Beneficiaries | 582 |
| Number Of Non Hispanic White Beneficiaries | 1338 |
| Number Of Black or African American Beneficiaries | 61 |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1137 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 319 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.5275 |