| National Provider Identifier [NPI]: | 1255384616 |
| Last Name Of The Provider | STIPANOV |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 605 GLENWOOD DR |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | CHATTANOOGA |
| Zip Code Of The Provider | 374041130 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 152 |
| Number Of Services | 183394 |
| Number Of Medicare Beneficiaries | 907 |
| Total Submitted Charge Amount | 3670388 |
| Total Medicare Allowed Amount | 2348481.24 |
| Total Medicare Payment Amount | 1831918.32 |
| Total Medicare Standardized Payment Amount | 1850415.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 64 |
| Number Of Drug Services | 163398 |
| Number Of Medicare Beneficiaries With Drug Services | 314 |
| Total Drug Submitted ChargeAmount | 2528966 |
| Total Drug Medicare AllowedAmount | 1885217.59 |
| Total Drug Medicare PaymentAmount | 1470826.36 |
| Total Drug Medicare Standardized Payment Amount | 1470826.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 88 |
| Number Of Medical Services | 19996 |
| Number Of Medicare Beneficiaries With Medical Services | 907 |
| Total Medical Submitted Charge Amount | 1141422 |
| Total Medical Medicare Allowed Amount | 463263.65 |
| Total Medical Medicare Payment Amount | 361091.96 |
| Total Medical Medicare Standardized Payment Amount | 379588.94 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 103 |
| Number Of Beneficiaries Age 65 to 74 | 389 |
| Number Of Beneficiaries Age 75 to 84 | 304 |
| Number Of Beneficiaries Age Greater 84 | 111 |
| Number Of Female Beneficiaries | 522 |
| Number Of Male Beneficiaries | 385 |
| Number Of Non Hispanic White Beneficiaries | 836 |
| Number Of Black or African American Beneficiaries | 58 |
| 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 | 782 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 125 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 42 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.931 |