| National Provider Identifier [NPI]: | 1306855069 |
| Last Name Of The Provider | NIEDEREE |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1101 N ROCK RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | DERBY |
| Zip Code Of The Provider | 670373735 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 298 |
| Number Of Services | 21831 |
| Number Of Medicare Beneficiaries | 1059 |
| Total Submitted Charge Amount | 1143636 |
| Total Medicare Allowed Amount | 534528.28 |
| Total Medicare Payment Amount | 409641.62 |
| Total Medicare Standardized Payment Amount | 440800.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 27 |
| Number Of Drug Services | 9911 |
| Number Of Medicare Beneficiaries With Drug Services | 444 |
| Total Drug Submitted ChargeAmount | 63779 |
| Total Drug Medicare AllowedAmount | 20902.94 |
| Total Drug Medicare PaymentAmount | 17906.78 |
| Total Drug Medicare Standardized Payment Amount | 17906.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 271 |
| Number Of Medical Services | 11920 |
| Number Of Medicare Beneficiaries With Medical Services | 1059 |
| Total Medical Submitted Charge Amount | 1079857 |
| Total Medical Medicare Allowed Amount | 513625.34 |
| Total Medical Medicare Payment Amount | 391734.84 |
| Total Medical Medicare Standardized Payment Amount | 422893.97 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 69 |
| Number Of Beneficiaries Age 65 to 74 | 509 |
| Number Of Beneficiaries Age 75 to 84 | 339 |
| Number Of Beneficiaries Age Greater 84 | 142 |
| Number Of Female Beneficiaries | 635 |
| Number Of Male Beneficiaries | 424 |
| Number Of Non Hispanic White Beneficiaries | 1011 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1031 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 32 |
| Percent Of With Hypertension | 43 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.8631 |