National Provider Identifier [NPI]: |
1497736904 |
Last Name Of The Provider |
RUYLE |
First Name Of The Provider |
MATTHEW |
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 |
9930 WATSON RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631261827 |
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 |
211 |
Number Of Services |
5666.5 |
Number Of Medicare Beneficiaries |
1384 |
Total Submitted Charge Amount |
513400.23 |
Total Medicare Allowed Amount |
191954.33 |
Total Medicare Payment Amount |
147584.36 |
Total Medicare Standardized Payment Amount |
151066.62 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
2899.5 |
Number Of Medicare Beneficiaries With Drug Services |
170 |
Total Drug Submitted ChargeAmount |
8517 |
Total Drug Medicare AllowedAmount |
2218.29 |
Total Drug Medicare PaymentAmount |
1718.05 |
Total Drug Medicare Standardized Payment Amount |
1718.05 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
203 |
Number Of Medical Services |
2767 |
Number Of Medicare Beneficiaries With Medical Services |
1384 |
Total Medical Submitted Charge Amount |
504883.23 |
Total Medical Medicare Allowed Amount |
189736.04 |
Total Medical Medicare Payment Amount |
145866.31 |
Total Medical Medicare Standardized Payment Amount |
149348.57 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
307 |
Number Of Beneficiaries Age 65 to 74 |
526 |
Number Of Beneficiaries Age 75 to 84 |
353 |
Number Of Beneficiaries Age Greater 84 |
198 |
Number Of Female Beneficiaries |
830 |
Number Of Male Beneficiaries |
554 |
Number Of Non Hispanic White Beneficiaries |
1249 |
Number Of Black or African American Beneficiaries |
97 |
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 |
16 |
Number Of Beneficiaries With Medicare Only Entitlement |
1070 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
314 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
59 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.6646 |