| National Provider Identifier [NPI]: | 1790736122 |
| Last Name Of The Provider | WALLENTINE |
| First Name Of The Provider | STEVEN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1055 N 500 W |
| Street Address 2 Of The Provider | SUITE 202 |
| City Of The Provider | PROVO |
| Zip Code Of The Provider | 846043305 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 201 |
| Number Of Services | 163366 |
| Number Of Medicare Beneficiaries | 1327 |
| Total Submitted Charge Amount | 4876282.02 |
| Total Medicare Allowed Amount | 2590207.82 |
| Total Medicare Payment Amount | 2010993.71 |
| Total Medicare Standardized Payment Amount | 2031168.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 74 |
| Number Of Drug Services | 144075 |
| Number Of Medicare Beneficiaries With Drug Services | 318 |
| Total Drug Submitted ChargeAmount | 4124227.02 |
| Total Drug Medicare AllowedAmount | 2237224.5 |
| Total Drug Medicare PaymentAmount | 1726940.37 |
| Total Drug Medicare Standardized Payment Amount | 1726940.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 127 |
| Number Of Medical Services | 19291 |
| Number Of Medicare Beneficiaries With Medical Services | 1323 |
| Total Medical Submitted Charge Amount | 752055 |
| Total Medical Medicare Allowed Amount | 352983.32 |
| Total Medical Medicare Payment Amount | 284053.34 |
| Total Medical Medicare Standardized Payment Amount | 304227.77 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 129 |
| Number Of Beneficiaries Age 65 to 74 | 592 |
| Number Of Beneficiaries Age 75 to 84 | 475 |
| Number Of Beneficiaries Age Greater 84 | 131 |
| Number Of Female Beneficiaries | 785 |
| Number Of Male Beneficiaries | 542 |
| Number Of Non Hispanic White Beneficiaries | 1268 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1215 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 112 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 35 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.5845 |