| National Provider Identifier [NPI]: | 1568531382 |
| Last Name Of The Provider | SHILE |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 411 HAMILTON BLVD |
| Street Address 2 Of The Provider | 1824 |
| City Of The Provider | PEORIA |
| Zip Code Of The Provider | 616021144 |
| 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 | 67 |
| Number Of Services | 7521 |
| Number Of Medicare Beneficiaries | 4086 |
| Total Submitted Charge Amount | 730617 |
| Total Medicare Allowed Amount | 155653.31 |
| Total Medicare Payment Amount | 135914.03 |
| Total Medicare Standardized Payment Amount | 137234.67 |
| 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 | 67 |
| Number Of Medical Services | 7521 |
| Number Of Medicare Beneficiaries With Medical Services | 4086 |
| Total Medical Submitted Charge Amount | 730617 |
| Total Medical Medicare Allowed Amount | 155653.31 |
| Total Medical Medicare Payment Amount | 135914.03 |
| Total Medical Medicare Standardized Payment Amount | 137234.67 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 535 |
| Number Of Beneficiaries Age 65 to 74 | 2252 |
| Number Of Beneficiaries Age 75 to 84 | 1042 |
| Number Of Beneficiaries Age Greater 84 | 257 |
| Number Of Female Beneficiaries | 3619 |
| Number Of Male Beneficiaries | 467 |
| Number Of Non Hispanic White Beneficiaries | 3776 |
| Number Of Black or African American Beneficiaries | 209 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 40 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 39 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3550 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 536 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9408 |