| National Provider Identifier [NPI]: | 1689627960 |
| Last Name Of The Provider | VIETH |
| First Name Of The Provider | CHAD |
| 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 | 2116 W FAIDLEY AVE |
| Street Address 2 Of The Provider | STE 400 |
| City Of The Provider | GRAND ISLAND |
| Zip Code Of The Provider | 688034671 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 137 |
| Number Of Services | 4667.5 |
| Number Of Medicare Beneficiaries | 618 |
| Total Submitted Charge Amount | 467822 |
| Total Medicare Allowed Amount | 207922.3 |
| Total Medicare Payment Amount | 159355.86 |
| Total Medicare Standardized Payment Amount | 171084.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 277.5 |
| Number Of Medicare Beneficiaries With Drug Services | 110 |
| Total Drug Submitted ChargeAmount | 9094 |
| Total Drug Medicare AllowedAmount | 5930.48 |
| Total Drug Medicare PaymentAmount | 5580.09 |
| Total Drug Medicare Standardized Payment Amount | 5580.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 121 |
| Number Of Medical Services | 4390 |
| Number Of Medicare Beneficiaries With Medical Services | 617 |
| Total Medical Submitted Charge Amount | 458728 |
| Total Medical Medicare Allowed Amount | 201991.82 |
| Total Medical Medicare Payment Amount | 153775.77 |
| Total Medical Medicare Standardized Payment Amount | 165504.81 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 122 |
| Number Of Beneficiaries Age 65 to 74 | 260 |
| Number Of Beneficiaries Age 75 to 84 | 161 |
| Number Of Beneficiaries Age Greater 84 | 75 |
| Number Of Female Beneficiaries | 356 |
| Number Of Male Beneficiaries | 262 |
| Number Of Non Hispanic White Beneficiaries | 573 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 444 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 174 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.2174 |