| National Provider Identifier [NPI]: | 1437165263 |
| Last Name Of The Provider | AVENDANIO |
| First Name Of The Provider | TROY |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1101 W LIBERTY ST |
| Street Address 2 Of The Provider | DEPT. OF RADIOLOGY |
| City Of The Provider | FARMINGTON |
| Zip Code Of The Provider | 636401921 |
| 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 | 211 |
| Number Of Services | 7625 |
| Number Of Medicare Beneficiaries | 4229 |
| Total Submitted Charge Amount | 746407 |
| Total Medicare Allowed Amount | 208740.33 |
| Total Medicare Payment Amount | 157133.59 |
| Total Medicare Standardized Payment Amount | 166680.27 |
| 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 | 211 |
| Number Of Medical Services | 7625 |
| Number Of Medicare Beneficiaries With Medical Services | 4229 |
| Total Medical Submitted Charge Amount | 746407 |
| Total Medical Medicare Allowed Amount | 208740.33 |
| Total Medical Medicare Payment Amount | 157133.59 |
| Total Medical Medicare Standardized Payment Amount | 166680.27 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 1159 |
| Number Of Beneficiaries Age 65 to 74 | 1406 |
| Number Of Beneficiaries Age 75 to 84 | 1164 |
| Number Of Beneficiaries Age Greater 84 | 500 |
| Number Of Female Beneficiaries | 2632 |
| Number Of Male Beneficiaries | 1597 |
| Number Of Non Hispanic White Beneficiaries | 4150 |
| Number Of Black or African American Beneficiaries | 27 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2864 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1365 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4423 |