| National Provider Identifier [NPI]: | 1750589263 |
| Last Name Of The Provider | GALBRAITH |
| First Name Of The Provider | DANA |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 59 GRASSO PLZ |
| Street Address 2 Of The Provider | |
| City Of The Provider | AFFTON |
| Zip Code Of The Provider | 631233107 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 1314 |
| Number Of Medicare Beneficiaries | 107 |
| Total Submitted Charge Amount | 86771 |
| Total Medicare Allowed Amount | 42659.42 |
| Total Medicare Payment Amount | 30724.74 |
| Total Medicare Standardized Payment Amount | 31178.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 725 |
| Number Of Medicare Beneficiaries With Drug Services | 47 |
| Total Drug Submitted ChargeAmount | 23538 |
| Total Drug Medicare AllowedAmount | 11894.52 |
| Total Drug Medicare PaymentAmount | 9782.79 |
| Total Drug Medicare Standardized Payment Amount | 9782.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 589 |
| Number Of Medicare Beneficiaries With Medical Services | 107 |
| Total Medical Submitted Charge Amount | 63233 |
| Total Medical Medicare Allowed Amount | 30764.9 |
| Total Medical Medicare Payment Amount | 20941.95 |
| Total Medical Medicare Standardized Payment Amount | 21395.62 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 46 |
| Number Of Beneficiaries Age 75 to 84 | 31 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 90 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 23 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0549 |