| National Provider Identifier [NPI]: | 1528085156 |
| Last Name Of The Provider | ROBERTS |
| First Name Of The Provider | GUY |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 555 W PINE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | FARMINGTON |
| Zip Code Of The Provider | 636401426 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 72 |
| Number Of Services | 4437 |
| Number Of Medicare Beneficiaries | 1411 |
| Total Submitted Charge Amount | 489709.41 |
| Total Medicare Allowed Amount | 321655.53 |
| Total Medicare Payment Amount | 215618.38 |
| Total Medicare Standardized Payment Amount | 239845.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 393 |
| Number Of Medicare Beneficiaries With Drug Services | 260 |
| Total Drug Submitted ChargeAmount | 14154.03 |
| Total Drug Medicare AllowedAmount | 7810.82 |
| Total Drug Medicare PaymentAmount | 7487.09 |
| Total Drug Medicare Standardized Payment Amount | 7487.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 4044 |
| Number Of Medicare Beneficiaries With Medical Services | 1411 |
| Total Medical Submitted Charge Amount | 475555.38 |
| Total Medical Medicare Allowed Amount | 313844.71 |
| Total Medical Medicare Payment Amount | 208131.29 |
| Total Medical Medicare Standardized Payment Amount | 232358.41 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 342 |
| Number Of Beneficiaries Age 65 to 74 | 523 |
| Number Of Beneficiaries Age 75 to 84 | 361 |
| Number Of Beneficiaries Age Greater 84 | 185 |
| Number Of Female Beneficiaries | 818 |
| Number Of Male Beneficiaries | 593 |
| Number Of Non Hispanic White Beneficiaries | 1375 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 979 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 432 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2619 |