| National Provider Identifier [NPI]: | 1770513319 |
| Last Name Of The Provider | ALLEN |
| First Name Of The Provider | BRENT |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 555 N. NEW BALLAS |
| Street Address 2 Of The Provider | SUITE 265 |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631412330 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Vascular Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 125 |
| Number Of Services | 4233 |
| Number Of Medicare Beneficiaries | 1698 |
| Total Submitted Charge Amount | 2063105 |
| Total Medicare Allowed Amount | 630441.3 |
| Total Medicare Payment Amount | 477940.99 |
| Total Medicare Standardized Payment Amount | 490125.68 |
| 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 | 125 |
| Number Of Medical Services | 4233 |
| Number Of Medicare Beneficiaries With Medical Services | 1698 |
| Total Medical Submitted Charge Amount | 2063105 |
| Total Medical Medicare Allowed Amount | 630441.3 |
| Total Medical Medicare Payment Amount | 477940.99 |
| Total Medical Medicare Standardized Payment Amount | 490125.68 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 146 |
| Number Of Beneficiaries Age 65 to 74 | 614 |
| Number Of Beneficiaries Age 75 to 84 | 627 |
| Number Of Beneficiaries Age Greater 84 | 311 |
| Number Of Female Beneficiaries | 840 |
| Number Of Male Beneficiaries | 858 |
| Number Of Non Hispanic White Beneficiaries | 1503 |
| Number Of Black or African American Beneficiaries | 158 |
| 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 | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1519 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 179 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.0193 |