| National Provider Identifier [NPI]: | 1689642779 |
| Last Name Of The Provider | FIEDERLEIN |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1411 S CREASY LN |
| Street Address 2 Of The Provider | SUITE 130 |
| City Of The Provider | LAFAYETTE |
| Zip Code Of The Provider | 479057438 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 198 |
| Number Of Services | 35335 |
| Number Of Medicare Beneficiaries | 1799 |
| Total Submitted Charge Amount | 3144855 |
| Total Medicare Allowed Amount | 448996.19 |
| Total Medicare Payment Amount | 343240.7 |
| Total Medicare Standardized Payment Amount | 368852.72 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 31240 |
| Number Of Medicare Beneficiaries With Drug Services | 301 |
| Total Drug Submitted ChargeAmount | 80061 |
| Total Drug Medicare AllowedAmount | 9190.88 |
| Total Drug Medicare PaymentAmount | 7008.42 |
| Total Drug Medicare Standardized Payment Amount | 7008.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 194 |
| Number Of Medical Services | 4095 |
| Number Of Medicare Beneficiaries With Medical Services | 1798 |
| Total Medical Submitted Charge Amount | 3064794 |
| Total Medical Medicare Allowed Amount | 439805.31 |
| Total Medical Medicare Payment Amount | 336232.28 |
| Total Medical Medicare Standardized Payment Amount | 361844.3 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 269 |
| Number Of Beneficiaries Age 65 to 74 | 721 |
| Number Of Beneficiaries Age 75 to 84 | 557 |
| Number Of Beneficiaries Age Greater 84 | 252 |
| Number Of Female Beneficiaries | 1074 |
| Number Of Male Beneficiaries | 725 |
| Number Of Non Hispanic White Beneficiaries | 1734 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1418 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 381 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3732 |