| National Provider Identifier [NPI]: | 1851330906 |
| Last Name Of The Provider | HUMPHREY |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3024 BUSINESS PARK CIR |
| Street Address 2 Of The Provider | |
| City Of The Provider | GOODLETTSVILLE |
| Zip Code Of The Provider | 370723132 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 173 |
| Number Of Services | 6153 |
| Number Of Medicare Beneficiaries | 3694 |
| Total Submitted Charge Amount | 703960.57 |
| Total Medicare Allowed Amount | 154344.69 |
| Total Medicare Payment Amount | 118623.48 |
| Total Medicare Standardized Payment Amount | 126862.27 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 584 |
| Number Of Beneficiaries Age 65 to 74 | 1456 |
| Number Of Beneficiaries Age 75 to 84 | 1065 |
| Number Of Beneficiaries Age Greater 84 | 589 |
| Number Of Female Beneficiaries | 2408 |
| Number Of Male Beneficiaries | 1286 |
| Number Of Non Hispanic White Beneficiaries | 3327 |
| Number Of Black or African American Beneficiaries | 302 |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2962 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 732 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5537 |