| National Provider Identifier [NPI]: | 1851357032 |
| Last Name Of The Provider | HAASE |
| First Name Of The Provider | GREGORY |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1540 PROVIDENT DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | WARSAW |
| Zip Code Of The Provider | 465803291 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 1249 |
| Number Of Medicare Beneficiaries | 437 |
| Total Submitted Charge Amount | 199495 |
| Total Medicare Allowed Amount | 90260.48 |
| Total Medicare Payment Amount | 63624.21 |
| Total Medicare Standardized Payment Amount | 68588.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 37 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 1797 |
| Total Drug Medicare AllowedAmount | 771.7 |
| Total Drug Medicare PaymentAmount | 733.99 |
| Total Drug Medicare Standardized Payment Amount | 733.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 1212 |
| Number Of Medicare Beneficiaries With Medical Services | 437 |
| Total Medical Submitted Charge Amount | 197698 |
| Total Medical Medicare Allowed Amount | 89488.78 |
| Total Medical Medicare Payment Amount | 62890.22 |
| Total Medical Medicare Standardized Payment Amount | 67854.14 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 75 |
| Number Of Beneficiaries Age 65 to 74 | 136 |
| Number Of Beneficiaries Age 75 to 84 | 138 |
| Number Of Beneficiaries Age Greater 84 | 88 |
| Number Of Female Beneficiaries | 253 |
| Number Of Male Beneficiaries | 184 |
| Number Of Non Hispanic White Beneficiaries | 424 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 323 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 114 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.6397 |