| National Provider Identifier [NPI]: | 1235223561 |
| Last Name Of The Provider | GUTIERREZ |
| First Name Of The Provider | FERNANDO |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 510 S KINGSHIGHWAY BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631101016 |
| 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 | 65 |
| Number Of Services | 4886 |
| Number Of Medicare Beneficiaries | 3207 |
| Total Submitted Charge Amount | 480229 |
| Total Medicare Allowed Amount | 103872.85 |
| Total Medicare Payment Amount | 79912.91 |
| Total Medicare Standardized Payment Amount | 83050.11 |
| 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 | 65 |
| Number Of Medical Services | 4886 |
| Number Of Medicare Beneficiaries With Medical Services | 3207 |
| Total Medical Submitted Charge Amount | 480229 |
| Total Medical Medicare Allowed Amount | 103872.85 |
| Total Medical Medicare Payment Amount | 79912.91 |
| Total Medical Medicare Standardized Payment Amount | 83050.11 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 1008 |
| Number Of Beneficiaries Age 65 to 74 | 1217 |
| Number Of Beneficiaries Age 75 to 84 | 700 |
| Number Of Beneficiaries Age Greater 84 | 282 |
| Number Of Female Beneficiaries | 1568 |
| Number Of Male Beneficiaries | 1639 |
| Number Of Non Hispanic White Beneficiaries | 2381 |
| Number Of Black or African American Beneficiaries | 724 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 46 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2181 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1026 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 54 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.5071 |