| National Provider Identifier [NPI]: | 1184608143 |
| Last Name Of The Provider | KEETCH |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12855 N 40 DR |
| Street Address 2 Of The Provider | SUITE 375 |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631418635 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 103 |
| Number Of Services | 16265 |
| Number Of Medicare Beneficiaries | 1220 |
| Total Submitted Charge Amount | 1070200.66 |
| Total Medicare Allowed Amount | 498966.72 |
| Total Medicare Payment Amount | 367845.07 |
| Total Medicare Standardized Payment Amount | 380437.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 9859 |
| Number Of Medicare Beneficiaries With Drug Services | 154 |
| Total Drug Submitted ChargeAmount | 245349 |
| Total Drug Medicare AllowedAmount | 96263.95 |
| Total Drug Medicare PaymentAmount | 73440.38 |
| Total Drug Medicare Standardized Payment Amount | 73440.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 93 |
| Number Of Medical Services | 6406 |
| Number Of Medicare Beneficiaries With Medical Services | 1219 |
| Total Medical Submitted Charge Amount | 824851.66 |
| Total Medical Medicare Allowed Amount | 402702.77 |
| Total Medical Medicare Payment Amount | 294404.69 |
| Total Medical Medicare Standardized Payment Amount | 306997.07 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 530 |
| Number Of Beneficiaries Age 75 to 84 | 457 |
| Number Of Beneficiaries Age Greater 84 | 186 |
| Number Of Female Beneficiaries | 162 |
| Number Of Male Beneficiaries | 1058 |
| Number Of Non Hispanic White Beneficiaries | 1104 |
| Number Of Black or African American Beneficiaries | 84 |
| 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 | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1192 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 32 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1496 |