| National Provider Identifier [NPI]: | 1417982760 |
| Last Name Of The Provider | FERN |
| First Name Of The Provider | STEVEN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11525 OLDE CABIN RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CREVE COEUR |
| Zip Code Of The Provider | 631417146 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Critical Care (Intensivists) |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 79 |
| Number Of Services | 7474 |
| Number Of Medicare Beneficiaries | 857 |
| Total Submitted Charge Amount | 1233721.17 |
| Total Medicare Allowed Amount | 408152.72 |
| Total Medicare Payment Amount | 308382.39 |
| Total Medicare Standardized Payment Amount | 307944.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 4783 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 268317.66 |
| Total Drug Medicare AllowedAmount | 101004.6 |
| Total Drug Medicare PaymentAmount | 72196.6 |
| Total Drug Medicare Standardized Payment Amount | 72196.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 2691 |
| Number Of Medicare Beneficiaries With Medical Services | 857 |
| Total Medical Submitted Charge Amount | 965403.51 |
| Total Medical Medicare Allowed Amount | 307148.12 |
| Total Medical Medicare Payment Amount | 236185.79 |
| Total Medical Medicare Standardized Payment Amount | 235747.62 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 120 |
| Number Of Beneficiaries Age 65 to 74 | 390 |
| Number Of Beneficiaries Age 75 to 84 | 245 |
| Number Of Beneficiaries Age Greater 84 | 102 |
| Number Of Female Beneficiaries | 445 |
| Number Of Male Beneficiaries | 412 |
| Number Of Non Hispanic White Beneficiaries | 774 |
| Number Of Black or African American Beneficiaries | 71 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 764 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 93 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4406 |