| National Provider Identifier [NPI]: | 1194772061 |
| Last Name Of The Provider | WADDELL |
| First Name Of The Provider | BRAD |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 417 STATE ST |
| Street Address 2 Of The Provider | SUITE 330 WEBBER EAST |
| City Of The Provider | BANGOR |
| Zip Code Of The Provider | 044016630 |
| State Code Of The Provider | ME |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Surgical Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 72 |
| Number Of Services | 469 |
| Number Of Medicare Beneficiaries | 282 |
| Total Submitted Charge Amount | 263514 |
| Total Medicare Allowed Amount | 84566.79 |
| Total Medicare Payment Amount | 65524.34 |
| Total Medicare Standardized Payment Amount | 70383.72 |
| 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 | 72 |
| Number Of Medical Services | 469 |
| Number Of Medicare Beneficiaries With Medical Services | 282 |
| Total Medical Submitted Charge Amount | 263514 |
| Total Medical Medicare Allowed Amount | 84566.79 |
| Total Medical Medicare Payment Amount | 65524.34 |
| Total Medical Medicare Standardized Payment Amount | 70383.72 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 64 |
| Number Of Beneficiaries Age 65 to 74 | 114 |
| Number Of Beneficiaries Age 75 to 84 | 80 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 174 |
| Number Of Male Beneficiaries | 108 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 160 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 122 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 35 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.5761 |