| National Provider Identifier [NPI]: | 1457383796 |
| Last Name Of The Provider | GAU |
| First Name Of The Provider | MEGAN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12303 DEPAUL DR |
| Street Address 2 Of The Provider | DEPAUL HEALTH CENTER |
| City Of The Provider | BRIDGETON |
| Zip Code Of The Provider | 63044 |
| 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 | 166 |
| Number Of Services | 10765 |
| Number Of Medicare Beneficiaries | 5587 |
| Total Submitted Charge Amount | 1011763.62 |
| Total Medicare Allowed Amount | 269185.15 |
| Total Medicare Payment Amount | 213391.22 |
| Total Medicare Standardized Payment Amount | 218422.71 |
| 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 | 166 |
| Number Of Medical Services | 10765 |
| Number Of Medicare Beneficiaries With Medical Services | 5587 |
| Total Medical Submitted Charge Amount | 1011763.62 |
| Total Medical Medicare Allowed Amount | 269185.15 |
| Total Medical Medicare Payment Amount | 213391.22 |
| Total Medical Medicare Standardized Payment Amount | 218422.71 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 1281 |
| Number Of Beneficiaries Age 65 to 74 | 1996 |
| Number Of Beneficiaries Age 75 to 84 | 1399 |
| Number Of Beneficiaries Age Greater 84 | 911 |
| Number Of Female Beneficiaries | 3634 |
| Number Of Male Beneficiaries | 1953 |
| Number Of Non Hispanic White Beneficiaries | 4065 |
| Number Of Black or African American Beneficiaries | 1396 |
| Number Of AsianPacific Islander Beneficiaries | 34 |
| Number Of Hispanic Beneficiaries | 49 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 43 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4063 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1524 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.9157 |