| National Provider Identifier [NPI]: | 1730284050 |
| Last Name Of The Provider | TIEDE |
| First Name Of The Provider | CHAD |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | O.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 825 FIFTH AVENUE |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | CHAMBERSBURG |
| Zip Code Of The Provider | 17201 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Optometry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 5473 |
| Number Of Medicare Beneficiaries | 2092 |
| Total Submitted Charge Amount | 528463 |
| Total Medicare Allowed Amount | 453080.47 |
| Total Medicare Payment Amount | 315238.79 |
| Total Medicare Standardized Payment Amount | 312290.7 |
| 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 | 23 |
| Number Of Medical Services | 5473 |
| Number Of Medicare Beneficiaries With Medical Services | 2092 |
| Total Medical Submitted Charge Amount | 528463 |
| Total Medical Medicare Allowed Amount | 453080.47 |
| Total Medical Medicare Payment Amount | 315238.79 |
| Total Medical Medicare Standardized Payment Amount | 312290.7 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 177 |
| Number Of Beneficiaries Age 65 to 74 | 822 |
| Number Of Beneficiaries Age 75 to 84 | 755 |
| Number Of Beneficiaries Age Greater 84 | 338 |
| Number Of Female Beneficiaries | 1313 |
| Number Of Male Beneficiaries | 779 |
| Number Of Non Hispanic White Beneficiaries | 1971 |
| Number Of Black or African American Beneficiaries | 68 |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1807 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 285 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1468 |