| National Provider Identifier [NPI]: | 1609861723 |
| Last Name Of The Provider | STEVENSON |
| First Name Of The Provider | KAREN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 75 SOCKANOSSET CROSS RD |
| Street Address 2 Of The Provider | SUITE100 |
| City Of The Provider | CRANSTON |
| Zip Code Of The Provider | 029205558 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 1440 |
| Number Of Medicare Beneficiaries | 291 |
| Total Submitted Charge Amount | 165202.26 |
| Total Medicare Allowed Amount | 107019.61 |
| Total Medicare Payment Amount | 79763.89 |
| Total Medicare Standardized Payment Amount | 78632.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 139 |
| Number Of Medicare Beneficiaries With Drug Services | 85 |
| Total Drug Submitted ChargeAmount | 4122.26 |
| Total Drug Medicare AllowedAmount | 2621.05 |
| Total Drug Medicare PaymentAmount | 2547.8 |
| Total Drug Medicare Standardized Payment Amount | 2547.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 1301 |
| Number Of Medicare Beneficiaries With Medical Services | 290 |
| Total Medical Submitted Charge Amount | 161080 |
| Total Medical Medicare Allowed Amount | 104398.56 |
| Total Medical Medicare Payment Amount | 77216.09 |
| Total Medical Medicare Standardized Payment Amount | 76084.68 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 32 |
| Number Of Beneficiaries Age 65 to 74 | 134 |
| Number Of Beneficiaries Age 75 to 84 | 81 |
| Number Of Beneficiaries Age Greater 84 | 44 |
| Number Of Female Beneficiaries | 254 |
| Number Of Male Beneficiaries | 37 |
| Number Of Non Hispanic White Beneficiaries | 272 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 254 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 37 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0788 |