| National Provider Identifier [NPI]: | 1518051846 |
| Last Name Of The Provider | BHALLA |
| First Name Of The Provider | SANJEEV |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| 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 | 73 |
| Number Of Services | 5018 |
| Number Of Medicare Beneficiaries | 3097 |
| Total Submitted Charge Amount | 660859 |
| Total Medicare Allowed Amount | 138630.08 |
| Total Medicare Payment Amount | 106691.54 |
| Total Medicare Standardized Payment Amount | 111240.94 |
| 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 | 73 |
| Number Of Medical Services | 5018 |
| Number Of Medicare Beneficiaries With Medical Services | 3097 |
| Total Medical Submitted Charge Amount | 660859 |
| Total Medical Medicare Allowed Amount | 138630.08 |
| Total Medical Medicare Payment Amount | 106691.54 |
| Total Medical Medicare Standardized Payment Amount | 111240.94 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 1022 |
| Number Of Beneficiaries Age 65 to 74 | 1172 |
| Number Of Beneficiaries Age 75 to 84 | 627 |
| Number Of Beneficiaries Age Greater 84 | 276 |
| Number Of Female Beneficiaries | 1578 |
| Number Of Male Beneficiaries | 1519 |
| Number Of Non Hispanic White Beneficiaries | 2225 |
| Number Of Black or African American Beneficiaries | 772 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 36 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2079 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1018 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 54 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.5535 |