| National Provider Identifier [NPI]: | 1982650990 |
| Last Name Of The Provider | LOCKE |
| First Name Of The Provider | JONATHAN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2300 N EDWARD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | DECATUR |
| Zip Code Of The Provider | 625264163 |
| 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 | 219 |
| Number Of Services | 11273 |
| Number Of Medicare Beneficiaries | 5895 |
| Total Submitted Charge Amount | 2385915 |
| Total Medicare Allowed Amount | 409315.79 |
| Total Medicare Payment Amount | 314513.67 |
| Total Medicare Standardized Payment Amount | 320559.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 219 |
| Number Of Medical Services | 11273 |
| Number Of Medicare Beneficiaries With Medical Services | 5895 |
| Total Medical Submitted Charge Amount | 2385915 |
| Total Medical Medicare Allowed Amount | 409315.79 |
| Total Medical Medicare Payment Amount | 314513.67 |
| Total Medical Medicare Standardized Payment Amount | 320559.37 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 795 |
| Number Of Beneficiaries Age 65 to 74 | 2410 |
| Number Of Beneficiaries Age 75 to 84 | 1786 |
| Number Of Beneficiaries Age Greater 84 | 904 |
| Number Of Female Beneficiaries | 3952 |
| Number Of Male Beneficiaries | 1943 |
| Number Of Non Hispanic White Beneficiaries | 5294 |
| Number Of Black or African American Beneficiaries | 525 |
| 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 | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4699 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1196 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3963 |