| National Provider Identifier [NPI]: | 1215943345 |
| Last Name Of The Provider | GREMMELS |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 70 DOCTORS PARK |
| Street Address 2 Of The Provider | |
| City Of The Provider | CAPE GIRARDEAU |
| Zip Code Of The Provider | 637034928 |
| 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 | 187 |
| Number Of Services | 11231 |
| Number Of Medicare Beneficiaries | 5798 |
| Total Submitted Charge Amount | 1044146 |
| Total Medicare Allowed Amount | 286603.36 |
| Total Medicare Payment Amount | 220623.34 |
| Total Medicare Standardized Payment Amount | 234971.19 |
| 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 | 187 |
| Number Of Medical Services | 11231 |
| Number Of Medicare Beneficiaries With Medical Services | 5798 |
| Total Medical Submitted Charge Amount | 1044146 |
| Total Medical Medicare Allowed Amount | 286603.36 |
| Total Medical Medicare Payment Amount | 220623.34 |
| Total Medical Medicare Standardized Payment Amount | 234971.19 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 1436 |
| Number Of Beneficiaries Age 65 to 74 | 2057 |
| Number Of Beneficiaries Age 75 to 84 | 1519 |
| Number Of Beneficiaries Age Greater 84 | 786 |
| Number Of Female Beneficiaries | 3306 |
| Number Of Male Beneficiaries | 2492 |
| Number Of Non Hispanic White Beneficiaries | 5405 |
| Number Of Black or African American Beneficiaries | 319 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 31 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4030 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1768 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5452 |