| National Provider Identifier [NPI]: | 1831391002 |
| Last Name Of The Provider | WELLER |
| First Name Of The Provider | CHRISTIN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3635 VISTA AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631102539 |
| 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 | 30 |
| Number Of Services | 4598 |
| Number Of Medicare Beneficiaries | 1229 |
| Total Submitted Charge Amount | 425408.8 |
| Total Medicare Allowed Amount | 145579.24 |
| Total Medicare Payment Amount | 110070.35 |
| Total Medicare Standardized Payment Amount | 84517.44 |
| 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 | 30 |
| Number Of Medical Services | 4598 |
| Number Of Medicare Beneficiaries With Medical Services | 1229 |
| Total Medical Submitted Charge Amount | 425408.8 |
| Total Medical Medicare Allowed Amount | 145579.24 |
| Total Medical Medicare Payment Amount | 110070.35 |
| Total Medical Medicare Standardized Payment Amount | 84517.44 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 245 |
| Number Of Beneficiaries Age 65 to 74 | 503 |
| Number Of Beneficiaries Age 75 to 84 | 343 |
| Number Of Beneficiaries Age Greater 84 | 138 |
| Number Of Female Beneficiaries | 665 |
| Number Of Male Beneficiaries | 564 |
| Number Of Non Hispanic White Beneficiaries | 1114 |
| Number Of Black or African American Beneficiaries | 87 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 989 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 240 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4354 |