| National Provider Identifier [NPI]: | 1215994967 |
| Last Name Of The Provider | SHAEFER |
| First Name Of The Provider | JANET |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2929 5TH ST |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | RAPID CITY |
| Zip Code Of The Provider | 577017363 |
| State Code Of The Provider | SD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 169 |
| Number Of Services | 7357 |
| Number Of Medicare Beneficiaries | 3018 |
| Total Submitted Charge Amount | 860305.08 |
| Total Medicare Allowed Amount | 224646.04 |
| Total Medicare Payment Amount | 180766.11 |
| Total Medicare Standardized Payment Amount | 184750.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 2327 |
| Number Of Medicare Beneficiaries With Drug Services | 39 |
| Total Drug Submitted ChargeAmount | 1126.32 |
| Total Drug Medicare AllowedAmount | 951.86 |
| Total Drug Medicare PaymentAmount | 746.22 |
| Total Drug Medicare Standardized Payment Amount | 746.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 165 |
| Number Of Medical Services | 5030 |
| Number Of Medicare Beneficiaries With Medical Services | 3018 |
| Total Medical Submitted Charge Amount | 859178.76 |
| Total Medical Medicare Allowed Amount | 223694.18 |
| Total Medical Medicare Payment Amount | 180019.89 |
| Total Medical Medicare Standardized Payment Amount | 184004.49 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 435 |
| Number Of Beneficiaries Age 65 to 74 | 1202 |
| Number Of Beneficiaries Age 75 to 84 | 915 |
| Number Of Beneficiaries Age Greater 84 | 466 |
| Number Of Female Beneficiaries | 2025 |
| Number Of Male Beneficiaries | 993 |
| Number Of Non Hispanic White Beneficiaries | 2656 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | 291 |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2422 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 596 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4509 |