| National Provider Identifier [NPI]: | 1619960606 |
| Last Name Of The Provider | THANAVARO |
| First Name Of The Provider | SAMER |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| 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 | SUITE 2346 |
| 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 | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 5080 |
| Number Of Medicare Beneficiaries | 2416 |
| Total Submitted Charge Amount | 787937 |
| Total Medicare Allowed Amount | 320311.9 |
| Total Medicare Payment Amount | 234016.12 |
| Total Medicare Standardized Payment Amount | 236391.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 196 |
| Number Of Medicare Beneficiaries With Drug Services | 49 |
| Total Drug Submitted ChargeAmount | 31360 |
| Total Drug Medicare AllowedAmount | 10381.83 |
| Total Drug Medicare PaymentAmount | 7901.78 |
| Total Drug Medicare Standardized Payment Amount | 7901.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 4884 |
| Number Of Medicare Beneficiaries With Medical Services | 2416 |
| Total Medical Submitted Charge Amount | 756577 |
| Total Medical Medicare Allowed Amount | 309930.07 |
| Total Medical Medicare Payment Amount | 226114.34 |
| Total Medical Medicare Standardized Payment Amount | 228489.49 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 440 |
| Number Of Beneficiaries Age 65 to 74 | 816 |
| Number Of Beneficiaries Age 75 to 84 | 732 |
| Number Of Beneficiaries Age Greater 84 | 428 |
| Number Of Female Beneficiaries | 1263 |
| Number Of Male Beneficiaries | 1153 |
| Number Of Non Hispanic White Beneficiaries | 1928 |
| Number Of Black or African American Beneficiaries | 438 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1849 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 567 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.9993 |