| National Provider Identifier [NPI]: | 1538358684 |
| Last Name Of The Provider | STEPHENSON |
| First Name Of The Provider | SHARISE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 750 WASHINGTON ST |
| Street Address 2 Of The Provider | BOX 314 |
| City Of The Provider | BOSTON |
| Zip Code Of The Provider | 021111526 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 3810 |
| Number Of Medicare Beneficiaries | 330 |
| Total Submitted Charge Amount | 308068.09 |
| Total Medicare Allowed Amount | 147716.87 |
| Total Medicare Payment Amount | 115440.94 |
| Total Medicare Standardized Payment Amount | 120906.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2631 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 35347.92 |
| Total Drug Medicare AllowedAmount | 13650.91 |
| Total Drug Medicare PaymentAmount | 10702.3 |
| Total Drug Medicare Standardized Payment Amount | 10702.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 1179 |
| Number Of Medicare Beneficiaries With Medical Services | 330 |
| Total Medical Submitted Charge Amount | 272720.17 |
| Total Medical Medicare Allowed Amount | 134065.96 |
| Total Medical Medicare Payment Amount | 104738.64 |
| Total Medical Medicare Standardized Payment Amount | 110204.3 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 96 |
| Number Of Beneficiaries Age 65 to 74 | 107 |
| Number Of Beneficiaries Age 75 to 84 | 77 |
| Number Of Beneficiaries Age Greater 84 | 50 |
| Number Of Female Beneficiaries | 212 |
| Number Of Male Beneficiaries | 118 |
| Number Of Non Hispanic White Beneficiaries | 219 |
| Number Of Black or African American Beneficiaries | 80 |
| 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 | 197 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 133 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 37 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 47 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 30 |
| Average HCC Risk Score Of Beneficiaries | 2.2052 |