| National Provider Identifier [NPI]: | 1851518476 |
| Last Name Of The Provider | DIETHELM |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 48 MEDICAL PARK DR E |
| Street Address 2 Of The Provider | SUITE 351 |
| City Of The Provider | BIRMINGHAM |
| Zip Code Of The Provider | 352353430 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 16185 |
| Number Of Medicare Beneficiaries | 1069 |
| Total Submitted Charge Amount | 495888 |
| Total Medicare Allowed Amount | 407344.87 |
| Total Medicare Payment Amount | 306766.15 |
| Total Medicare Standardized Payment Amount | 327650.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 13248 |
| Number Of Medicare Beneficiaries With Drug Services | 73 |
| Total Drug Submitted ChargeAmount | 105906 |
| Total Drug Medicare AllowedAmount | 72807.44 |
| Total Drug Medicare PaymentAmount | 56519.43 |
| Total Drug Medicare Standardized Payment Amount | 56519.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 2937 |
| Number Of Medicare Beneficiaries With Medical Services | 1069 |
| Total Medical Submitted Charge Amount | 389982 |
| Total Medical Medicare Allowed Amount | 334537.43 |
| Total Medical Medicare Payment Amount | 250246.72 |
| Total Medical Medicare Standardized Payment Amount | 271131.55 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 222 |
| Number Of Beneficiaries Age 65 to 74 | 365 |
| Number Of Beneficiaries Age 75 to 84 | 352 |
| Number Of Beneficiaries Age Greater 84 | 130 |
| Number Of Female Beneficiaries | 619 |
| Number Of Male Beneficiaries | 450 |
| Number Of Non Hispanic White Beneficiaries | 966 |
| 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 | 926 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 143 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 23 |
| Average HCC Risk Score Of Beneficiaries | 1.4433 |