| National Provider Identifier [NPI]: | 1912940024 |
| Last Name Of The Provider | DESAI |
| First Name Of The Provider | DEVANG |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 615 S NEW BALLAS RD |
| Street Address 2 Of The Provider | DEPT OF RADIOLOGY |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631418221 |
| 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 | 110 |
| Number Of Services | 2161 |
| Number Of Medicare Beneficiaries | 1693 |
| Total Submitted Charge Amount | 407010 |
| Total Medicare Allowed Amount | 84265.95 |
| Total Medicare Payment Amount | 61918.3 |
| Total Medicare Standardized Payment Amount | 63985.3 |
| 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 | 110 |
| Number Of Medical Services | 2161 |
| Number Of Medicare Beneficiaries With Medical Services | 1693 |
| Total Medical Submitted Charge Amount | 407010 |
| Total Medical Medicare Allowed Amount | 84265.95 |
| Total Medical Medicare Payment Amount | 61918.3 |
| Total Medical Medicare Standardized Payment Amount | 63985.3 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 388 |
| Number Of Beneficiaries Age 65 to 74 | 622 |
| Number Of Beneficiaries Age 75 to 84 | 453 |
| Number Of Beneficiaries Age Greater 84 | 230 |
| Number Of Female Beneficiaries | 984 |
| Number Of Male Beneficiaries | 709 |
| Number Of Non Hispanic White Beneficiaries | 1541 |
| Number Of Black or African American Beneficiaries | 117 |
| 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 | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1369 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 324 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7338 |