| National Provider Identifier [NPI]: | 1548244379 |
| Last Name Of The Provider | VOLLMAR |
| First Name Of The Provider | THEODORE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10010 KENNERLY RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631282106 |
| 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 | 170 |
| Number Of Services | 6305 |
| Number Of Medicare Beneficiaries | 3851 |
| Total Submitted Charge Amount | 559347 |
| Total Medicare Allowed Amount | 208544.37 |
| Total Medicare Payment Amount | 149131.87 |
| Total Medicare Standardized Payment Amount | 153017.49 |
| 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 | 170 |
| Number Of Medical Services | 6305 |
| Number Of Medicare Beneficiaries With Medical Services | 3851 |
| Total Medical Submitted Charge Amount | 559347 |
| Total Medical Medicare Allowed Amount | 208544.37 |
| Total Medical Medicare Payment Amount | 149131.87 |
| Total Medical Medicare Standardized Payment Amount | 153017.49 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 794 |
| Number Of Beneficiaries Age 65 to 74 | 1216 |
| Number Of Beneficiaries Age 75 to 84 | 1085 |
| Number Of Beneficiaries Age Greater 84 | 756 |
| Number Of Female Beneficiaries | 2263 |
| Number Of Male Beneficiaries | 1588 |
| Number Of Non Hispanic White Beneficiaries | 3664 |
| Number Of Black or African American Beneficiaries | 89 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 36 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3054 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 797 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 16 |
| 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 | 45 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.8423 |