| National Provider Identifier [NPI]: | 1912977661 |
| Last Name Of The Provider | GAEDDERT |
| First Name Of The Provider | WADE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2101 N WALDRON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | HUTCHINSON |
| Zip Code Of The Provider | 675021131 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Otolaryngology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 119 |
| Number Of Services | 2596 |
| Number Of Medicare Beneficiaries | 803 |
| Total Submitted Charge Amount | 1012063 |
| Total Medicare Allowed Amount | 301997.14 |
| Total Medicare Payment Amount | 228236.54 |
| Total Medicare Standardized Payment Amount | 213771.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 106 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 1378 |
| Total Drug Medicare AllowedAmount | 189.04 |
| Total Drug Medicare PaymentAmount | 148.19 |
| Total Drug Medicare Standardized Payment Amount | 148.19 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 118 |
| Number Of Medical Services | 2490 |
| Number Of Medicare Beneficiaries With Medical Services | 803 |
| Total Medical Submitted Charge Amount | 1010685 |
| Total Medical Medicare Allowed Amount | 301808.1 |
| Total Medical Medicare Payment Amount | 228088.35 |
| Total Medical Medicare Standardized Payment Amount | 213622.84 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 70 |
| Number Of Beneficiaries Age 65 to 74 | 275 |
| Number Of Beneficiaries Age 75 to 84 | 263 |
| Number Of Beneficiaries Age Greater 84 | 195 |
| Number Of Female Beneficiaries | 448 |
| Number Of Male Beneficiaries | 355 |
| Number Of Non Hispanic White Beneficiaries | 767 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 701 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 102 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| 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 | 20 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0614 |