| National Provider Identifier [NPI]: | 1831155894 |
| Last Name Of The Provider | HEIDEWALD |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1500 SW 10TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | TOPEKA |
| Zip Code Of The Provider | 666041301 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 1554 |
| Number Of Medicare Beneficiaries | 933 |
| Total Submitted Charge Amount | 316455 |
| Total Medicare Allowed Amount | 140605.08 |
| Total Medicare Payment Amount | 102702.74 |
| Total Medicare Standardized Payment Amount | 107224.53 |
| 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 | 34 |
| Number Of Medical Services | 1554 |
| Number Of Medicare Beneficiaries With Medical Services | 933 |
| Total Medical Submitted Charge Amount | 316455 |
| Total Medical Medicare Allowed Amount | 140605.08 |
| Total Medical Medicare Payment Amount | 102702.74 |
| Total Medical Medicare Standardized Payment Amount | 107224.53 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 327 |
| Number Of Beneficiaries Age 65 to 74 | 237 |
| Number Of Beneficiaries Age 75 to 84 | 209 |
| Number Of Beneficiaries Age Greater 84 | 160 |
| Number Of Female Beneficiaries | 537 |
| Number Of Male Beneficiaries | 396 |
| Number Of Non Hispanic White Beneficiaries | 785 |
| Number Of Black or African American Beneficiaries | 86 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 566 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 367 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 50 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.7504 |