| National Provider Identifier [NPI]: | 1811191661 |
| Last Name Of The Provider | LAKSHMI |
| First Name Of The Provider | MAGGE |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| 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 | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 165 |
| Number Of Services | 11883 |
| Number Of Medicare Beneficiaries | 2995 |
| Total Submitted Charge Amount | 1049844 |
| Total Medicare Allowed Amount | 248316.76 |
| Total Medicare Payment Amount | 183830.89 |
| Total Medicare Standardized Payment Amount | 189599.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 7251 |
| Number Of Medicare Beneficiaries With Drug Services | 138 |
| Total Drug Submitted ChargeAmount | 31263 |
| Total Drug Medicare AllowedAmount | 4399.77 |
| Total Drug Medicare PaymentAmount | 3345.54 |
| Total Drug Medicare Standardized Payment Amount | 3345.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 162 |
| Number Of Medical Services | 4632 |
| Number Of Medicare Beneficiaries With Medical Services | 2992 |
| Total Medical Submitted Charge Amount | 1018581 |
| Total Medical Medicare Allowed Amount | 243916.99 |
| Total Medical Medicare Payment Amount | 180485.35 |
| Total Medical Medicare Standardized Payment Amount | 186253.79 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 634 |
| Number Of Beneficiaries Age 65 to 74 | 875 |
| Number Of Beneficiaries Age 75 to 84 | 901 |
| Number Of Beneficiaries Age Greater 84 | 585 |
| Number Of Female Beneficiaries | 1700 |
| Number Of Male Beneficiaries | 1295 |
| Number Of Non Hispanic White Beneficiaries | 2460 |
| Number Of Black or African American Beneficiaries | 346 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 153 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1951 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1044 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.1362 |