| National Provider Identifier [NPI]: | 1588625693 |
| Last Name Of The Provider | GANNINGER |
| First Name Of The Provider | PAUL |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1585 WOODLAKE DR |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | CHESTERFIELD |
| Zip Code Of The Provider | 630175740 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 75 |
| Number Of Services | 950 |
| Number Of Medicare Beneficiaries | 236 |
| Total Submitted Charge Amount | 82299 |
| Total Medicare Allowed Amount | 56870.34 |
| Total Medicare Payment Amount | 37587.24 |
| Total Medicare Standardized Payment Amount | 39057.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 68 |
| Number Of Medicare Beneficiaries With Drug Services | 48 |
| Total Drug Submitted ChargeAmount | 2817 |
| Total Drug Medicare AllowedAmount | 1827.66 |
| Total Drug Medicare PaymentAmount | 1656.45 |
| Total Drug Medicare Standardized Payment Amount | 1656.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 67 |
| Number Of Medical Services | 882 |
| Number Of Medicare Beneficiaries With Medical Services | 236 |
| Total Medical Submitted Charge Amount | 79482 |
| Total Medical Medicare Allowed Amount | 55042.68 |
| Total Medical Medicare Payment Amount | 35930.79 |
| Total Medical Medicare Standardized Payment Amount | 37401.39 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 112 |
| Number Of Beneficiaries Age 75 to 84 | 60 |
| Number Of Beneficiaries Age Greater 84 | 29 |
| Number Of Female Beneficiaries | 130 |
| Number Of Male Beneficiaries | 106 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 218 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9646 |