| National Provider Identifier [NPI]: | 1578597290 |
| Last Name Of The Provider | PALMER |
| First Name Of The Provider | RONALD |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| 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 | Interventional Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 171 |
| Number Of Services | 6825 |
| Number Of Medicare Beneficiaries | 3843 |
| Total Submitted Charge Amount | 886680.31 |
| Total Medicare Allowed Amount | 207141.66 |
| Total Medicare Payment Amount | 159080.13 |
| Total Medicare Standardized Payment Amount | 164637.68 |
| 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 | 171 |
| Number Of Medical Services | 6825 |
| Number Of Medicare Beneficiaries With Medical Services | 3843 |
| Total Medical Submitted Charge Amount | 886680.31 |
| Total Medical Medicare Allowed Amount | 207141.66 |
| Total Medical Medicare Payment Amount | 159080.13 |
| Total Medical Medicare Standardized Payment Amount | 164637.68 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 1033 |
| Number Of Beneficiaries Age 65 to 74 | 1160 |
| Number Of Beneficiaries Age 75 to 84 | 944 |
| Number Of Beneficiaries Age Greater 84 | 706 |
| Number Of Female Beneficiaries | 2316 |
| Number Of Male Beneficiaries | 1527 |
| Number Of Non Hispanic White Beneficiaries | 2832 |
| Number Of Black or African American Beneficiaries | 927 |
| 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 | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2614 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1229 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.1677 |