| National Provider Identifier [NPI]: | 1932163565 |
| Last Name Of The Provider | WILDES |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 800 KENYON RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT DODGE |
| Zip Code Of The Provider | 505015776 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 88 |
| Number Of Services | 10019 |
| Number Of Medicare Beneficiaries | 2268 |
| Total Submitted Charge Amount | 1587915.56 |
| Total Medicare Allowed Amount | 682214.33 |
| Total Medicare Payment Amount | 513572.23 |
| Total Medicare Standardized Payment Amount | 556306.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 1204 |
| Number Of Medicare Beneficiaries With Drug Services | 300 |
| Total Drug Submitted ChargeAmount | 60765.88 |
| Total Drug Medicare AllowedAmount | 60765.88 |
| Total Drug Medicare PaymentAmount | 47202.81 |
| Total Drug Medicare Standardized Payment Amount | 47202.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 87 |
| Number Of Medical Services | 8815 |
| Number Of Medicare Beneficiaries With Medical Services | 2268 |
| Total Medical Submitted Charge Amount | 1527149.68 |
| Total Medical Medicare Allowed Amount | 621448.45 |
| Total Medical Medicare Payment Amount | 466369.42 |
| Total Medical Medicare Standardized Payment Amount | 509103.83 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 208 |
| Number Of Beneficiaries Age 65 to 74 | 686 |
| Number Of Beneficiaries Age 75 to 84 | 824 |
| Number Of Beneficiaries Age Greater 84 | 550 |
| Number Of Female Beneficiaries | 1088 |
| Number Of Male Beneficiaries | 1180 |
| Number Of Non Hispanic White Beneficiaries | 2219 |
| Number Of Black or African American Beneficiaries | 17 |
| 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 | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1930 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 338 |
| Percent Of With Atrial Fibrillation | 37 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 68 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4919 |