| National Provider Identifier [NPI]: | 1780700526 |
| Last Name Of The Provider | METTENBURG |
| First Name Of The Provider | JOSEPH |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD PHD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 510 S KINGSHIGHWAY BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631101016 |
| 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 | 55 |
| Number Of Services | 1742 |
| Number Of Medicare Beneficiaries | 1073 |
| Total Submitted Charge Amount | 441232.5 |
| Total Medicare Allowed Amount | 108899.81 |
| Total Medicare Payment Amount | 82988 |
| Total Medicare Standardized Payment Amount | 85936.41 |
| 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 | 55 |
| Number Of Medical Services | 1742 |
| Number Of Medicare Beneficiaries With Medical Services | 1073 |
| Total Medical Submitted Charge Amount | 441232.5 |
| Total Medical Medicare Allowed Amount | 108899.81 |
| Total Medical Medicare Payment Amount | 82988 |
| Total Medical Medicare Standardized Payment Amount | 85936.41 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 319 |
| Number Of Beneficiaries Age 65 to 74 | 342 |
| Number Of Beneficiaries Age 75 to 84 | 241 |
| Number Of Beneficiaries Age Greater 84 | 171 |
| Number Of Female Beneficiaries | 584 |
| Number Of Male Beneficiaries | 489 |
| Number Of Non Hispanic White Beneficiaries | 870 |
| Number Of Black or African American Beneficiaries | 171 |
| 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 | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 716 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 357 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 48 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 32 |
| Average HCC Risk Score Of Beneficiaries | 2.0325 |