| National Provider Identifier [NPI]: | 1053393389 |
| Last Name Of The Provider | VIERTHALER |
| First Name Of The Provider | CARL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2020 CENTRAL AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | DODGE CITY |
| Zip Code Of The Provider | 678016411 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 239 |
| Number Of Services | 55244 |
| Number Of Medicare Beneficiaries | 477 |
| Total Submitted Charge Amount | 1775753 |
| Total Medicare Allowed Amount | 809171.74 |
| Total Medicare Payment Amount | 637714.58 |
| Total Medicare Standardized Payment Amount | 643529.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 60 |
| Number Of Drug Services | 48428 |
| Number Of Medicare Beneficiaries With Drug Services | 186 |
| Total Drug Submitted ChargeAmount | 1266828 |
| Total Drug Medicare AllowedAmount | 602837.53 |
| Total Drug Medicare PaymentAmount | 473315.34 |
| Total Drug Medicare Standardized Payment Amount | 473315.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 179 |
| Number Of Medical Services | 6816 |
| Number Of Medicare Beneficiaries With Medical Services | 477 |
| Total Medical Submitted Charge Amount | 508925 |
| Total Medical Medicare Allowed Amount | 206334.21 |
| Total Medical Medicare Payment Amount | 164399.24 |
| Total Medical Medicare Standardized Payment Amount | 170214.01 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 161 |
| Number Of Beneficiaries Age 75 to 84 | 184 |
| Number Of Beneficiaries Age Greater 84 | 110 |
| Number Of Female Beneficiaries | 255 |
| Number Of Male Beneficiaries | 222 |
| Number Of Non Hispanic White Beneficiaries | 447 |
| 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 | 419 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 58 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3518 |