| National Provider Identifier [NPI]: | 1003045063 |
| Last Name Of The Provider | BECKER |
| First Name Of The Provider | NILS |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 660 S EUCLID AVE |
| Street Address 2 Of The Provider | DEPARTMENT OF PATHOLOGY & IMMUNOLOGY, CAMPUS BOX 8118 |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631101010 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 8 |
| Number Of Services | 1550 |
| Number Of Medicare Beneficiaries | 961 |
| Total Submitted Charge Amount | 340972.75 |
| Total Medicare Allowed Amount | 122981.69 |
| Total Medicare Payment Amount | 95672.63 |
| Total Medicare Standardized Payment Amount | 68736.73 |
| 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 | 8 |
| Number Of Medical Services | 1550 |
| Number Of Medicare Beneficiaries With Medical Services | 961 |
| Total Medical Submitted Charge Amount | 340972.75 |
| Total Medical Medicare Allowed Amount | 122981.69 |
| Total Medical Medicare Payment Amount | 95672.63 |
| Total Medical Medicare Standardized Payment Amount | 68736.73 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 426 |
| Number Of Beneficiaries Age 75 to 84 | 321 |
| Number Of Beneficiaries Age Greater 84 | 191 |
| Number Of Female Beneficiaries | 464 |
| Number Of Male Beneficiaries | 497 |
| Number Of Non Hispanic White Beneficiaries | 930 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 921 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 40 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9913 |