| National Provider Identifier [NPI]: | 1871526863 |
| Last Name Of The Provider | DESIMON |
| First Name Of The Provider | GABRIEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 232 S WOODS MILL RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHESTERFIELD |
| Zip Code Of The Provider | 630173417 |
| 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 | 142 |
| Number Of Services | 8279 |
| Number Of Medicare Beneficiaries | 4957 |
| Total Submitted Charge Amount | 620000 |
| Total Medicare Allowed Amount | 195651.95 |
| Total Medicare Payment Amount | 142318.97 |
| Total Medicare Standardized Payment Amount | 145045.72 |
| 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 | 142 |
| Number Of Medical Services | 8279 |
| Number Of Medicare Beneficiaries With Medical Services | 4957 |
| Total Medical Submitted Charge Amount | 620000 |
| Total Medical Medicare Allowed Amount | 195651.95 |
| Total Medical Medicare Payment Amount | 142318.97 |
| Total Medical Medicare Standardized Payment Amount | 145045.72 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 364 |
| Number Of Beneficiaries Age 65 to 74 | 1925 |
| Number Of Beneficiaries Age 75 to 84 | 1678 |
| Number Of Beneficiaries Age Greater 84 | 990 |
| Number Of Female Beneficiaries | 2976 |
| Number Of Male Beneficiaries | 1981 |
| Number Of Non Hispanic White Beneficiaries | 4585 |
| Number Of Black or African American Beneficiaries | 221 |
| Number Of AsianPacific Islander Beneficiaries | 71 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 43 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4576 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 381 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4634 |