| National Provider Identifier [NPI]: | 1679517833 |
| Last Name Of The Provider | WADE |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2831 WILMA RUDOLPH BLVD. |
| Street Address 2 Of The Provider | |
| City Of The Provider | CLARKSVILLE |
| Zip Code Of The Provider | 37040 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 115 |
| Number Of Services | 10062 |
| Number Of Medicare Beneficiaries | 1043 |
| Total Submitted Charge Amount | 511066.2 |
| Total Medicare Allowed Amount | 161575.55 |
| Total Medicare Payment Amount | 125268.18 |
| Total Medicare Standardized Payment Amount | 144057.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 8316 |
| Number Of Medicare Beneficiaries With Drug Services | 77 |
| Total Drug Submitted ChargeAmount | 1663.2 |
| Total Drug Medicare AllowedAmount | 1525.18 |
| Total Drug Medicare PaymentAmount | 1101.83 |
| Total Drug Medicare Standardized Payment Amount | 1101.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 114 |
| Number Of Medical Services | 1746 |
| Number Of Medicare Beneficiaries With Medical Services | 1041 |
| Total Medical Submitted Charge Amount | 509403 |
| Total Medical Medicare Allowed Amount | 160050.37 |
| Total Medical Medicare Payment Amount | 124166.35 |
| Total Medical Medicare Standardized Payment Amount | 142955.74 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 176 |
| Number Of Beneficiaries Age 65 to 74 | 535 |
| Number Of Beneficiaries Age 75 to 84 | 268 |
| Number Of Beneficiaries Age Greater 84 | 64 |
| Number Of Female Beneficiaries | 738 |
| Number Of Male Beneficiaries | 305 |
| Number Of Non Hispanic White Beneficiaries | 858 |
| Number Of Black or African American Beneficiaries | 138 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 929 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 114 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9697 |