| National Provider Identifier [NPI]: | 1972541126 |
| Last Name Of The Provider | HEATHERS |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3508 S LAFOUNTAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | KOKOMO |
| Zip Code Of The Provider | 469023803 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 3910 |
| Number Of Medicare Beneficiaries | 814 |
| Total Submitted Charge Amount | 342035 |
| Total Medicare Allowed Amount | 311919.75 |
| Total Medicare Payment Amount | 205061.75 |
| Total Medicare Standardized Payment Amount | 220024.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 154 |
| Number Of Medicare Beneficiaries With Drug Services | 57 |
| Total Drug Submitted ChargeAmount | 5525 |
| Total Drug Medicare AllowedAmount | 3803.03 |
| Total Drug Medicare PaymentAmount | 3649.16 |
| Total Drug Medicare Standardized Payment Amount | 3649.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 3756 |
| Number Of Medicare Beneficiaries With Medical Services | 814 |
| Total Medical Submitted Charge Amount | 336510 |
| Total Medical Medicare Allowed Amount | 308116.72 |
| Total Medical Medicare Payment Amount | 201412.59 |
| Total Medical Medicare Standardized Payment Amount | 216375.27 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 76 |
| Number Of Beneficiaries Age 65 to 74 | 384 |
| Number Of Beneficiaries Age 75 to 84 | 247 |
| Number Of Beneficiaries Age Greater 84 | 107 |
| Number Of Female Beneficiaries | 443 |
| Number Of Male Beneficiaries | 371 |
| Number Of Non Hispanic White Beneficiaries | 775 |
| Number Of Black or African American Beneficiaries | 23 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 760 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 54 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 1 |
| Average HCC Risk Score Of Beneficiaries | 1.0667 |