| National Provider Identifier [NPI]: | 1730142274 |
| Last Name Of The Provider | IGOU |
| First Name Of The Provider | DONNA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 615 S NEW BALLAS RD |
| Street Address 2 Of The Provider | DEPT OF RADIOLOGY |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631418221 |
| 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 | 117 |
| Number Of Services | 4747 |
| Number Of Medicare Beneficiaries | 3112 |
| Total Submitted Charge Amount | 577413.76 |
| Total Medicare Allowed Amount | 124158.91 |
| Total Medicare Payment Amount | 94776.82 |
| Total Medicare Standardized Payment Amount | 96917.29 |
| 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 | 117 |
| Number Of Medical Services | 4747 |
| Number Of Medicare Beneficiaries With Medical Services | 3112 |
| Total Medical Submitted Charge Amount | 577413.76 |
| Total Medical Medicare Allowed Amount | 124158.91 |
| Total Medical Medicare Payment Amount | 94776.82 |
| Total Medical Medicare Standardized Payment Amount | 96917.29 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 551 |
| Number Of Beneficiaries Age 65 to 74 | 1318 |
| Number Of Beneficiaries Age 75 to 84 | 856 |
| Number Of Beneficiaries Age Greater 84 | 387 |
| Number Of Female Beneficiaries | 2098 |
| Number Of Male Beneficiaries | 1014 |
| Number Of Non Hispanic White Beneficiaries | 2789 |
| Number Of Black or African American Beneficiaries | 224 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 39 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2635 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 477 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.6005 |