| National Provider Identifier [NPI]: | 1699869925 |
| Last Name Of The Provider | FISCHER |
| First Name Of The Provider | KEITH |
| Middle Initial Of The Provider | C |
| 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 | 37 |
| Number Of Services | 844 |
| Number Of Medicare Beneficiaries | 764 |
| Total Submitted Charge Amount | 213003 |
| Total Medicare Allowed Amount | 45792.09 |
| Total Medicare Payment Amount | 36085.67 |
| Total Medicare Standardized Payment Amount | 36449.37 |
| 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 | 37 |
| Number Of Medical Services | 844 |
| Number Of Medicare Beneficiaries With Medical Services | 764 |
| Total Medical Submitted Charge Amount | 213003 |
| Total Medical Medicare Allowed Amount | 45792.09 |
| Total Medical Medicare Payment Amount | 36085.67 |
| Total Medical Medicare Standardized Payment Amount | 36449.37 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 166 |
| Number Of Beneficiaries Age 65 to 74 | 363 |
| Number Of Beneficiaries Age 75 to 84 | 177 |
| Number Of Beneficiaries Age Greater 84 | 58 |
| Number Of Female Beneficiaries | 433 |
| Number Of Male Beneficiaries | 331 |
| Number Of Non Hispanic White Beneficiaries | 589 |
| Number Of Black or African American Beneficiaries | 156 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 601 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 163 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 36 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.7898 |