| National Provider Identifier [NPI]: | 1023011004 |
| Last Name Of The Provider | STENSLAND |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7910 W JEFFERSON BLVD |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | FORT WAYNE |
| Zip Code Of The Provider | 468044159 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 2147 |
| Number Of Medicare Beneficiaries | 518 |
| Total Submitted Charge Amount | 1178027.24 |
| Total Medicare Allowed Amount | 197858.75 |
| Total Medicare Payment Amount | 139024.12 |
| Total Medicare Standardized Payment Amount | 140791.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 262 |
| Number Of Medicare Beneficiaries With Drug Services | 152 |
| Total Drug Submitted ChargeAmount | 6008 |
| Total Drug Medicare AllowedAmount | 1956.34 |
| Total Drug Medicare PaymentAmount | 1508.47 |
| Total Drug Medicare Standardized Payment Amount | 1508.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 1885 |
| Number Of Medicare Beneficiaries With Medical Services | 518 |
| Total Medical Submitted Charge Amount | 1172019.24 |
| Total Medical Medicare Allowed Amount | 195902.41 |
| Total Medical Medicare Payment Amount | 137515.65 |
| Total Medical Medicare Standardized Payment Amount | 139283.24 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 164 |
| Number Of Beneficiaries Age 65 to 74 | 174 |
| Number Of Beneficiaries Age 75 to 84 | 127 |
| Number Of Beneficiaries Age Greater 84 | 53 |
| Number Of Female Beneficiaries | 318 |
| Number Of Male Beneficiaries | 200 |
| Number Of Non Hispanic White Beneficiaries | 479 |
| Number Of Black or African American Beneficiaries | 20 |
| 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 | 397 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 121 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1886 |