| National Provider Identifier [NPI]: | 1588863906 |
| Last Name Of The Provider | WHITE |
| First Name Of The Provider | STEPHANIE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1011 BOWLES AVE |
| Street Address 2 Of The Provider | SUITE 205 |
| City Of The Provider | FENTON |
| Zip Code Of The Provider | 630262395 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 2776 |
| Number Of Medicare Beneficiaries | 1504 |
| Total Submitted Charge Amount | 354383 |
| Total Medicare Allowed Amount | 170156.01 |
| Total Medicare Payment Amount | 129267.17 |
| Total Medicare Standardized Payment Amount | 130706.75 |
| 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 | 51 |
| Number Of Medical Services | 2776 |
| Number Of Medicare Beneficiaries With Medical Services | 1504 |
| Total Medical Submitted Charge Amount | 354383 |
| Total Medical Medicare Allowed Amount | 170156.01 |
| Total Medical Medicare Payment Amount | 129267.17 |
| Total Medical Medicare Standardized Payment Amount | 130706.75 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 355 |
| Number Of Beneficiaries Age 65 to 74 | 484 |
| Number Of Beneficiaries Age 75 to 84 | 391 |
| Number Of Beneficiaries Age Greater 84 | 274 |
| Number Of Female Beneficiaries | 895 |
| Number Of Male Beneficiaries | 609 |
| Number Of Non Hispanic White Beneficiaries | 828 |
| Number Of Black or African American Beneficiaries | 636 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 987 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 517 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.3348 |