| National Provider Identifier [NPI]: | 1063525160 |
| Last Name Of The Provider | BASLER |
| First Name Of The Provider | JOSEPH |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 800 E CARPENTER ST |
| Street Address 2 Of The Provider | DEPARTMENT OF RADIOLOGY |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 627025324 |
| 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 | 181 |
| Number Of Services | 3186 |
| Number Of Medicare Beneficiaries | 2088 |
| Total Submitted Charge Amount | 606865 |
| Total Medicare Allowed Amount | 98444.52 |
| Total Medicare Payment Amount | 71643.63 |
| Total Medicare Standardized Payment Amount | 72868.59 |
| 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 | 181 |
| Number Of Medical Services | 3186 |
| Number Of Medicare Beneficiaries With Medical Services | 2088 |
| Total Medical Submitted Charge Amount | 606865 |
| Total Medical Medicare Allowed Amount | 98444.52 |
| Total Medical Medicare Payment Amount | 71643.63 |
| Total Medical Medicare Standardized Payment Amount | 72868.59 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 417 |
| Number Of Beneficiaries Age 65 to 74 | 712 |
| Number Of Beneficiaries Age 75 to 84 | 601 |
| Number Of Beneficiaries Age Greater 84 | 358 |
| Number Of Female Beneficiaries | 1125 |
| Number Of Male Beneficiaries | 963 |
| Number Of Non Hispanic White Beneficiaries | 1966 |
| Number Of Black or African American Beneficiaries | 92 |
| 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 | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1473 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 615 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6097 |