| National Provider Identifier [NPI]: | 1417038852 |
| Last Name Of The Provider | HOUSER |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 E PENNSYLVANIA AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PEORIA |
| Zip Code Of The Provider | 616033089 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 550 |
| Number Of Medicare Beneficiaries | 100 |
| Total Submitted Charge Amount | 51226 |
| Total Medicare Allowed Amount | 24757.36 |
| Total Medicare Payment Amount | 17207.58 |
| Total Medicare Standardized Payment Amount | 18200.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 43 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 3350 |
| Total Drug Medicare AllowedAmount | 2178.06 |
| Total Drug Medicare PaymentAmount | 2114.91 |
| Total Drug Medicare Standardized Payment Amount | 2114.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 507 |
| Number Of Medicare Beneficiaries With Medical Services | 100 |
| Total Medical Submitted Charge Amount | 47876 |
| Total Medical Medicare Allowed Amount | 22579.3 |
| Total Medical Medicare Payment Amount | 15092.67 |
| Total Medical Medicare Standardized Payment Amount | 16085.27 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 46 |
| Number Of Beneficiaries Age 75 to 84 | 32 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 57 |
| Number Of Male Beneficiaries | 43 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.023 |