| National Provider Identifier [NPI]: | 1366480022 |
| Last Name Of The Provider | SCHLEPPHORST |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3050 MONTVALE DR STE A |
| Street Address 2 Of The Provider | |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 627046924 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 248 |
| Number Of Services | 14410 |
| Number Of Medicare Beneficiaries | 3961 |
| Total Submitted Charge Amount | 1733006.72 |
| Total Medicare Allowed Amount | 290430.22 |
| Total Medicare Payment Amount | 229883.11 |
| Total Medicare Standardized Payment Amount | 241233.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 7204 |
| Number Of Medicare Beneficiaries With Drug Services | 104 |
| Total Drug Submitted ChargeAmount | 17394.19 |
| Total Drug Medicare AllowedAmount | 2124.4 |
| Total Drug Medicare PaymentAmount | 1665.64 |
| Total Drug Medicare Standardized Payment Amount | 1665.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 244 |
| Number Of Medical Services | 7206 |
| Number Of Medicare Beneficiaries With Medical Services | 3961 |
| Total Medical Submitted Charge Amount | 1715612.53 |
| Total Medical Medicare Allowed Amount | 288305.82 |
| Total Medical Medicare Payment Amount | 228217.47 |
| Total Medical Medicare Standardized Payment Amount | 239568.26 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 694 |
| Number Of Beneficiaries Age 65 to 74 | 1365 |
| Number Of Beneficiaries Age 75 to 84 | 1158 |
| Number Of Beneficiaries Age Greater 84 | 744 |
| Number Of Female Beneficiaries | 2544 |
| Number Of Male Beneficiaries | 1417 |
| Number Of Non Hispanic White Beneficiaries | 3822 |
| Number Of Black or African American Beneficiaries | 95 |
| 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 | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2861 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1100 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4429 |