| National Provider Identifier [NPI]: | 1144217233 |
| Last Name Of The Provider | SIEVERT |
| First Name Of The Provider | LAURA |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1316 OLD HIGHWAY 63 S |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | COLUMBIA |
| Zip Code Of The Provider | 652016092 |
| 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 | 223 |
| Number Of Services | 11468 |
| Number Of Medicare Beneficiaries | 5856 |
| Total Submitted Charge Amount | 1433786.81 |
| Total Medicare Allowed Amount | 367384.04 |
| Total Medicare Payment Amount | 289848.77 |
| Total Medicare Standardized Payment Amount | 304294.71 |
| 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 | 223 |
| Number Of Medical Services | 11468 |
| Number Of Medicare Beneficiaries With Medical Services | 5856 |
| Total Medical Submitted Charge Amount | 1433786.81 |
| Total Medical Medicare Allowed Amount | 367384.04 |
| Total Medical Medicare Payment Amount | 289848.77 |
| Total Medical Medicare Standardized Payment Amount | 304294.71 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 736 |
| Number Of Beneficiaries Age 65 to 74 | 2396 |
| Number Of Beneficiaries Age 75 to 84 | 1835 |
| Number Of Beneficiaries Age Greater 84 | 889 |
| Number Of Female Beneficiaries | 3988 |
| Number Of Male Beneficiaries | 1868 |
| Number Of Non Hispanic White Beneficiaries | 5594 |
| Number Of Black or African American Beneficiaries | 178 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 43 |
| Number Of Beneficiaries With Medicare Only Entitlement | 5049 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 807 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4003 |