| National Provider Identifier [NPI]: | 1124007380 |
| Last Name Of The Provider | BARAM |
| First Name Of The Provider | VADIM |
| Middle Initial Of The Provider | Y |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10420 OLD OLIVE STREET RD |
| Street Address 2 Of The Provider | STE 205 |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631415914 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 7959 |
| Number Of Medicare Beneficiaries | 1242 |
| Total Submitted Charge Amount | 1021990 |
| Total Medicare Allowed Amount | 649271.9 |
| Total Medicare Payment Amount | 498334 |
| Total Medicare Standardized Payment Amount | 503550.73 |
| 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 | 21 |
| Number Of Medical Services | 7959 |
| Number Of Medicare Beneficiaries With Medical Services | 1242 |
| Total Medical Submitted Charge Amount | 1021990 |
| Total Medical Medicare Allowed Amount | 649271.9 |
| Total Medical Medicare Payment Amount | 498334 |
| Total Medical Medicare Standardized Payment Amount | 503550.73 |
| Average Age Of Beneficiaries | 59 |
| Number Of Beneficiaries Age Less65 | 747 |
| Number Of Beneficiaries Age 65 to 74 | 198 |
| Number Of Beneficiaries Age 75 to 84 | 189 |
| Number Of Beneficiaries Age Greater 84 | 108 |
| Number Of Female Beneficiaries | 669 |
| Number Of Male Beneficiaries | 573 |
| Number Of Non Hispanic White Beneficiaries | 712 |
| Number Of Black or African American Beneficiaries | 494 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 364 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 878 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 37 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 75 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 60 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.0712 |