| National Provider Identifier [NPI]: | 1154449361 |
| Last Name Of The Provider | CZEYDA-POMMERSHEIM |
| First Name Of The Provider | FERENC |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 510 S KINGSHIGHWAY BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631101016 |
| 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 | 54 |
| Number Of Services | 3927 |
| Number Of Medicare Beneficiaries | 2283 |
| Total Submitted Charge Amount | 256832 |
| Total Medicare Allowed Amount | 69432.34 |
| Total Medicare Payment Amount | 52240.28 |
| Total Medicare Standardized Payment Amount | 53642.62 |
| 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 | 54 |
| Number Of Medical Services | 3927 |
| Number Of Medicare Beneficiaries With Medical Services | 2283 |
| Total Medical Submitted Charge Amount | 256832 |
| Total Medical Medicare Allowed Amount | 69432.34 |
| Total Medical Medicare Payment Amount | 52240.28 |
| Total Medical Medicare Standardized Payment Amount | 53642.62 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 667 |
| Number Of Beneficiaries Age 65 to 74 | 799 |
| Number Of Beneficiaries Age 75 to 84 | 505 |
| Number Of Beneficiaries Age Greater 84 | 312 |
| Number Of Female Beneficiaries | 1162 |
| Number Of Male Beneficiaries | 1121 |
| Number Of Non Hispanic White Beneficiaries | 1883 |
| Number Of Black or African American Beneficiaries | 327 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1509 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 774 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 54 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.7707 |