| National Provider Identifier [NPI]: | 1720296940 |
| Last Name Of The Provider | NIENABER |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2301 HOUSE AVE |
| Street Address 2 Of The Provider | SUITE 301 |
| City Of The Provider | CHEYENNE |
| Zip Code Of The Provider | 820013176 |
| State Code Of The Provider | WY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 5347 |
| Number Of Medicare Beneficiaries | 2428 |
| Total Submitted Charge Amount | 717975.49 |
| Total Medicare Allowed Amount | 185188.46 |
| Total Medicare Payment Amount | 134989.51 |
| Total Medicare Standardized Payment Amount | 138775.45 |
| 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 | 60 |
| Number Of Medical Services | 5347 |
| Number Of Medicare Beneficiaries With Medical Services | 2428 |
| Total Medical Submitted Charge Amount | 717975.49 |
| Total Medical Medicare Allowed Amount | 185188.46 |
| Total Medical Medicare Payment Amount | 134989.51 |
| Total Medical Medicare Standardized Payment Amount | 138775.45 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 310 |
| Number Of Beneficiaries Age 65 to 74 | 868 |
| Number Of Beneficiaries Age 75 to 84 | 844 |
| Number Of Beneficiaries Age Greater 84 | 406 |
| Number Of Female Beneficiaries | 1267 |
| Number Of Male Beneficiaries | 1161 |
| Number Of Non Hispanic White Beneficiaries | 2141 |
| Number Of Black or African American Beneficiaries | 39 |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| Number Of Hispanic Beneficiaries | 186 |
| Number Of American Indian Alaska Native Beneficiaries | 13 |
| Number Of Beneficiaries With Race Not Else where Classified | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2016 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 412 |
| Percent Of With Atrial Fibrillation | 31 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.422 |