| National Provider Identifier [NPI]: | 1629232491 |
| Last Name Of The Provider | DEETZ |
| First Name Of The Provider | CARL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D./PH.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 BARNES JEWISH PLAZA |
| Street Address 2 Of The Provider | DEPARTMENT OF PATHOLOGY AND IMMUNOLOGY |
| City Of The Provider | ST. LOUIS |
| Zip Code Of The Provider | 63110 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 4309 |
| Number Of Medicare Beneficiaries | 1649 |
| Total Submitted Charge Amount | 958454 |
| Total Medicare Allowed Amount | 144297.36 |
| Total Medicare Payment Amount | 105199.74 |
| Total Medicare Standardized Payment Amount | 91411.93 |
| 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 | 4309 |
| Number Of Medicare Beneficiaries With Medical Services | 1649 |
| Total Medical Submitted Charge Amount | 958454 |
| Total Medical Medicare Allowed Amount | 144297.36 |
| Total Medical Medicare Payment Amount | 105199.74 |
| Total Medical Medicare Standardized Payment Amount | 91411.93 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 305 |
| Number Of Beneficiaries Age 65 to 74 | 689 |
| Number Of Beneficiaries Age 75 to 84 | 459 |
| Number Of Beneficiaries Age Greater 84 | 196 |
| Number Of Female Beneficiaries | 973 |
| Number Of Male Beneficiaries | 676 |
| Number Of Non Hispanic White Beneficiaries | 1616 |
| Number Of Black or African American Beneficiaries | 15 |
| 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 | 1169 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 480 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1122 |