| National Provider Identifier [NPI]: | 1215988167 |
| Last Name Of The Provider | MEYER |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1725 W HARRISON ST |
| Street Address 2 Of The Provider | SUITE 456 |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606123841 |
| 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 | 101 |
| Number Of Services | 16067 |
| Number Of Medicare Beneficiaries | 4363 |
| Total Submitted Charge Amount | 1101078 |
| Total Medicare Allowed Amount | 186115.23 |
| Total Medicare Payment Amount | 141788.22 |
| Total Medicare Standardized Payment Amount | 136884.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 7830 |
| Number Of Medicare Beneficiaries With Drug Services | 90 |
| Total Drug Submitted ChargeAmount | 35760 |
| Total Drug Medicare AllowedAmount | 2628.16 |
| Total Drug Medicare PaymentAmount | 2060.19 |
| Total Drug Medicare Standardized Payment Amount | 2060.19 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 99 |
| Number Of Medical Services | 8237 |
| Number Of Medicare Beneficiaries With Medical Services | 4363 |
| Total Medical Submitted Charge Amount | 1065318 |
| Total Medical Medicare Allowed Amount | 183487.07 |
| Total Medical Medicare Payment Amount | 139728.03 |
| Total Medical Medicare Standardized Payment Amount | 134824.14 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 1040 |
| Number Of Beneficiaries Age 65 to 74 | 1743 |
| Number Of Beneficiaries Age 75 to 84 | 1149 |
| Number Of Beneficiaries Age Greater 84 | 431 |
| Number Of Female Beneficiaries | 2695 |
| Number Of Male Beneficiaries | 1668 |
| Number Of Non Hispanic White Beneficiaries | 1781 |
| Number Of Black or African American Beneficiaries | 1783 |
| Number Of AsianPacific Islander Beneficiaries | 85 |
| Number Of Hispanic Beneficiaries | 656 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2614 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1749 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.0185 |