| National Provider Identifier [NPI]: | 1124076732 |
| Last Name Of The Provider | WADLEY |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 233 NE 102ND AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PORTLAND |
| Zip Code Of The Provider | 972204106 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 140 |
| Number Of Services | 30595 |
| Number Of Medicare Beneficiaries | 3479 |
| Total Submitted Charge Amount | 1616153.39 |
| Total Medicare Allowed Amount | 495744.56 |
| Total Medicare Payment Amount | 389010.56 |
| Total Medicare Standardized Payment Amount | 395812.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 24948 |
| Number Of Medicare Beneficiaries With Drug Services | 247 |
| Total Drug Submitted ChargeAmount | 13652.17 |
| Total Drug Medicare AllowedAmount | 5200.35 |
| Total Drug Medicare PaymentAmount | 3741.68 |
| Total Drug Medicare Standardized Payment Amount | 3741.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 137 |
| Number Of Medical Services | 5647 |
| Number Of Medicare Beneficiaries With Medical Services | 3479 |
| Total Medical Submitted Charge Amount | 1602501.22 |
| Total Medical Medicare Allowed Amount | 490544.21 |
| Total Medical Medicare Payment Amount | 385268.88 |
| Total Medical Medicare Standardized Payment Amount | 392070.69 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 304 |
| Number Of Beneficiaries Age 65 to 74 | 1953 |
| Number Of Beneficiaries Age 75 to 84 | 920 |
| Number Of Beneficiaries Age Greater 84 | 302 |
| Number Of Female Beneficiaries | 2291 |
| Number Of Male Beneficiaries | 1188 |
| Number Of Non Hispanic White Beneficiaries | 2979 |
| Number Of Black or African American Beneficiaries | 101 |
| Number Of AsianPacific Islander Beneficiaries | 61 |
| Number Of Hispanic Beneficiaries | 273 |
| Number Of American Indian Alaska Native Beneficiaries | 11 |
| Number Of Beneficiaries With Race Not Else where Classified | 54 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3097 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 382 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0295 |