| National Provider Identifier [NPI]: | 1053303636 |
| Last Name Of The Provider | BUSSMANN |
| First Name Of The Provider | CARL |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M,D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11133 DUNN RD |
| Street Address 2 Of The Provider | DEPARTMENT OF EMS |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631366119 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 398 |
| Number Of Medicare Beneficiaries | 330 |
| Total Submitted Charge Amount | 396198 |
| Total Medicare Allowed Amount | 54209.6 |
| Total Medicare Payment Amount | 40563.12 |
| Total Medicare Standardized Payment Amount | 40740.66 |
| 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 | 24 |
| Number Of Medical Services | 398 |
| Number Of Medicare Beneficiaries With Medical Services | 330 |
| Total Medical Submitted Charge Amount | 396198 |
| Total Medical Medicare Allowed Amount | 54209.6 |
| Total Medical Medicare Payment Amount | 40563.12 |
| Total Medical Medicare Standardized Payment Amount | 40740.66 |
| Average Age Of Beneficiaries | 56 |
| Number Of Beneficiaries Age Less65 | 226 |
| Number Of Beneficiaries Age 65 to 74 | 54 |
| Number Of Beneficiaries Age 75 to 84 | 31 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 164 |
| Number Of Male Beneficiaries | 166 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 165 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 43 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 287 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 33 |
| Percent Of With Asthma | 21 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 62 |
| Percent Of With Diabetes | 55 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 52 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.194 |