National Provider Identifier [NPI]: |
1497931729 |
Last Name Of The Provider |
SKYLES |
First Name Of The Provider |
JASON |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
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 |
110 |
Number Of Services |
3571 |
Number Of Medicare Beneficiaries |
2103 |
Total Submitted Charge Amount |
314567.14 |
Total Medicare Allowed Amount |
83330.04 |
Total Medicare Payment Amount |
65641.08 |
Total Medicare Standardized Payment Amount |
66680.51 |
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 |
110 |
Number Of Medical Services |
3571 |
Number Of Medicare Beneficiaries With Medical Services |
2103 |
Total Medical Submitted Charge Amount |
314567.14 |
Total Medical Medicare Allowed Amount |
83330.04 |
Total Medical Medicare Payment Amount |
65641.08 |
Total Medical Medicare Standardized Payment Amount |
66680.51 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
328 |
Number Of Beneficiaries Age 65 to 74 |
940 |
Number Of Beneficiaries Age 75 to 84 |
601 |
Number Of Beneficiaries Age Greater 84 |
234 |
Number Of Female Beneficiaries |
1608 |
Number Of Male Beneficiaries |
495 |
Number Of Non Hispanic White Beneficiaries |
1890 |
Number Of Black or African American Beneficiaries |
153 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
20 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
20 |
Number Of Beneficiaries With Medicare Only Entitlement |
1798 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
305 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.423 |