| National Provider Identifier [NPI]: | 1659376390 |
| Last Name Of The Provider | OLDHAM |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | |
| 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 | RM H2241 |
| 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 | 23 |
| Number Of Services | 742 |
| Number Of Medicare Beneficiaries | 656 |
| Total Submitted Charge Amount | 609042.6 |
| Total Medicare Allowed Amount | 115236.67 |
| Total Medicare Payment Amount | 86835.47 |
| Total Medicare Standardized Payment Amount | 87569.28 |
| 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 | 23 |
| Number Of Medical Services | 742 |
| Number Of Medicare Beneficiaries With Medical Services | 656 |
| Total Medical Submitted Charge Amount | 609042.6 |
| Total Medical Medicare Allowed Amount | 115236.67 |
| Total Medical Medicare Payment Amount | 86835.47 |
| Total Medical Medicare Standardized Payment Amount | 87569.28 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 248 |
| Number Of Beneficiaries Age 65 to 74 | 177 |
| Number Of Beneficiaries Age 75 to 84 | 132 |
| Number Of Beneficiaries Age Greater 84 | 99 |
| Number Of Female Beneficiaries | 383 |
| Number Of Male Beneficiaries | 273 |
| Number Of Non Hispanic White Beneficiaries | 243 |
| Number Of Black or African American Beneficiaries | 402 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 319 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 337 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 56 |
| Percent Of With Chronic Kidney Disease | 56 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 46 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 20 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 2.8884 |