National Provider Identifier [NPI]: |
1780778027 |
Last Name Of The Provider |
SIEGEL |
First Name Of The Provider |
CARY |
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 |
510 S KINGSHIGHWAY BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631101016 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
137 |
Number Of Services |
3389 |
Number Of Medicare Beneficiaries |
2140 |
Total Submitted Charge Amount |
496770 |
Total Medicare Allowed Amount |
109725.73 |
Total Medicare Payment Amount |
85241.47 |
Total Medicare Standardized Payment Amount |
87273.36 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
137 |
Number Of Medical Services |
3389 |
Number Of Medicare Beneficiaries With Medical Services |
2140 |
Total Medical Submitted Charge Amount |
496770 |
Total Medical Medicare Allowed Amount |
109725.73 |
Total Medical Medicare Payment Amount |
85241.47 |
Total Medical Medicare Standardized Payment Amount |
87273.36 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
727 |
Number Of Beneficiaries Age 65 to 74 |
762 |
Number Of Beneficiaries Age 75 to 84 |
447 |
Number Of Beneficiaries Age Greater 84 |
204 |
Number Of Female Beneficiaries |
1085 |
Number Of Male Beneficiaries |
1055 |
Number Of Non Hispanic White Beneficiaries |
1479 |
Number Of Black or African American Beneficiaries |
602 |
Number Of AsianPacific Islander Beneficiaries |
13 |
Number Of Hispanic Beneficiaries |
23 |
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 |
1365 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
775 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
58 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.4365 |