| National Provider Identifier [NPI]: | 1306004247 |
| Last Name Of The Provider | SCHAFFERT |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 101 E MILLER RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | STERLING |
| Zip Code Of The Provider | 610811252 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 1760 |
| Number Of Medicare Beneficiaries | 496 |
| Total Submitted Charge Amount | 314278.76 |
| Total Medicare Allowed Amount | 111905.04 |
| Total Medicare Payment Amount | 82180.65 |
| Total Medicare Standardized Payment Amount | 84320.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 77 |
| Number Of Medicare Beneficiaries With Drug Services | 66 |
| Total Drug Submitted ChargeAmount | 3615 |
| Total Drug Medicare AllowedAmount | 2523.04 |
| Total Drug Medicare PaymentAmount | 2466.38 |
| Total Drug Medicare Standardized Payment Amount | 2466.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 1683 |
| Number Of Medicare Beneficiaries With Medical Services | 496 |
| Total Medical Submitted Charge Amount | 310663.76 |
| Total Medical Medicare Allowed Amount | 109382 |
| Total Medical Medicare Payment Amount | 79714.27 |
| Total Medical Medicare Standardized Payment Amount | 81853.92 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 91 |
| Number Of Beneficiaries Age 65 to 74 | 159 |
| Number Of Beneficiaries Age 75 to 84 | 153 |
| Number Of Beneficiaries Age Greater 84 | 93 |
| Number Of Female Beneficiaries | 282 |
| Number Of Male Beneficiaries | 214 |
| Number Of Non Hispanic White Beneficiaries | 475 |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 383 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 113 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4758 |