| National Provider Identifier [NPI]: | 1174575773 |
| Last Name Of The Provider | GARRETT |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3635 VISTA AVE |
| Street Address 2 Of The Provider | DEPT OF RADIOLOGY; ST. LOUIS UNIV HOSP |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631102539 |
| 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 | 4480 |
| Number Of Medicare Beneficiaries | 2186 |
| Total Submitted Charge Amount | 294147 |
| Total Medicare Allowed Amount | 134611.86 |
| Total Medicare Payment Amount | 98704.63 |
| Total Medicare Standardized Payment Amount | 101240.86 |
| 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 | 4480 |
| Number Of Medicare Beneficiaries With Medical Services | 2186 |
| Total Medical Submitted Charge Amount | 294147 |
| Total Medical Medicare Allowed Amount | 134611.86 |
| Total Medical Medicare Payment Amount | 98704.63 |
| Total Medical Medicare Standardized Payment Amount | 101240.86 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 898 |
| Number Of Beneficiaries Age 65 to 74 | 717 |
| Number Of Beneficiaries Age 75 to 84 | 388 |
| Number Of Beneficiaries Age Greater 84 | 183 |
| Number Of Female Beneficiaries | 1079 |
| Number Of Male Beneficiaries | 1107 |
| Number Of Non Hispanic White Beneficiaries | 1263 |
| Number Of Black or African American Beneficiaries | 837 |
| Number Of AsianPacific Islander Beneficiaries | 31 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1115 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1071 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.4888 |