| National Provider Identifier [NPI]: | 1003883562 |
| Last Name Of The Provider | PRAGER |
| First Name Of The Provider | DIANE |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8940 N WOOD SAGE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | PEORIA |
| Zip Code Of The Provider | 61615 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 204 |
| Number Of Services | 179434 |
| Number Of Medicare Beneficiaries | 1465 |
| Total Submitted Charge Amount | 9085538.5 |
| Total Medicare Allowed Amount | 2855427.01 |
| Total Medicare Payment Amount | 2219305.92 |
| Total Medicare Standardized Payment Amount | 2230107.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 96 |
| Number Of Drug Services | 170108 |
| Number Of Medicare Beneficiaries With Drug Services | 775 |
| Total Drug Submitted ChargeAmount | 6585554.5 |
| Total Drug Medicare AllowedAmount | 2299210.19 |
| Total Drug Medicare PaymentAmount | 1785239.01 |
| Total Drug Medicare Standardized Payment Amount | 1785239.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 108 |
| Number Of Medical Services | 9326 |
| Number Of Medicare Beneficiaries With Medical Services | 1464 |
| Total Medical Submitted Charge Amount | 2499984 |
| Total Medical Medicare Allowed Amount | 556216.82 |
| Total Medical Medicare Payment Amount | 434066.91 |
| Total Medical Medicare Standardized Payment Amount | 444868.45 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 162 |
| Number Of Beneficiaries Age 65 to 74 | 642 |
| Number Of Beneficiaries Age 75 to 84 | 516 |
| Number Of Beneficiaries Age Greater 84 | 145 |
| Number Of Female Beneficiaries | 899 |
| Number Of Male Beneficiaries | 566 |
| Number Of Non Hispanic White Beneficiaries | 1347 |
| Number Of Black or African American Beneficiaries | 93 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1252 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 213 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 55 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.9321 |