| National Provider Identifier [NPI]: | 1841494689 |
| Last Name Of The Provider | OTTO |
| First Name Of The Provider | RANDALL |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12639 OLD TESSON RD |
| Street Address 2 Of The Provider | SUITE 115 |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631282786 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 102 |
| Number Of Services | 1810 |
| Number Of Medicare Beneficiaries | 373 |
| Total Submitted Charge Amount | 1115592 |
| Total Medicare Allowed Amount | 216264.3 |
| Total Medicare Payment Amount | 162788.45 |
| Total Medicare Standardized Payment Amount | 168458.72 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 195 |
| Number Of Medicare Beneficiaries With Drug Services | 116 |
| Total Drug Submitted ChargeAmount | 2340 |
| Total Drug Medicare AllowedAmount | 1098.19 |
| Total Drug Medicare PaymentAmount | 791.46 |
| Total Drug Medicare Standardized Payment Amount | 791.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 100 |
| Number Of Medical Services | 1615 |
| Number Of Medicare Beneficiaries With Medical Services | 373 |
| Total Medical Submitted Charge Amount | 1113252 |
| Total Medical Medicare Allowed Amount | 215166.11 |
| Total Medical Medicare Payment Amount | 161996.99 |
| Total Medical Medicare Standardized Payment Amount | 167667.26 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 62 |
| Number Of Beneficiaries Age 65 to 74 | 142 |
| Number Of Beneficiaries Age 75 to 84 | 109 |
| Number Of Beneficiaries Age Greater 84 | 60 |
| Number Of Female Beneficiaries | 235 |
| Number Of Male Beneficiaries | 138 |
| Number Of Non Hispanic White Beneficiaries | 361 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 318 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 55 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 20 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 68 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5571 |