| National Provider Identifier [NPI]: | 1033176656 |
| Last Name Of The Provider | WATERS |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2300 N EDWARD ST |
| Street Address 2 Of The Provider | STE 2400 |
| City Of The Provider | DECATUR |
| Zip Code Of The Provider | 625264163 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 7034 |
| Number Of Medicare Beneficiaries | 3307 |
| Total Submitted Charge Amount | 1400863.74 |
| Total Medicare Allowed Amount | 292432.71 |
| Total Medicare Payment Amount | 217381.74 |
| Total Medicare Standardized Payment Amount | 220038.81 |
| 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 | 73 |
| Number Of Medical Services | 7034 |
| Number Of Medicare Beneficiaries With Medical Services | 3307 |
| Total Medical Submitted Charge Amount | 1400863.74 |
| Total Medical Medicare Allowed Amount | 292432.71 |
| Total Medical Medicare Payment Amount | 217381.74 |
| Total Medical Medicare Standardized Payment Amount | 220038.81 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 495 |
| Number Of Beneficiaries Age 65 to 74 | 1133 |
| Number Of Beneficiaries Age 75 to 84 | 1033 |
| Number Of Beneficiaries Age Greater 84 | 646 |
| Number Of Female Beneficiaries | 1788 |
| Number Of Male Beneficiaries | 1519 |
| Number Of Non Hispanic White Beneficiaries | 2909 |
| Number Of Black or African American Beneficiaries | 359 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2484 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 823 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6273 |