| National Provider Identifier [NPI]: | 1003836164 |
| Last Name Of The Provider | HEETDERKS |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2442 WINNE AVE STE 1 |
| Street Address 2 Of The Provider | |
| City Of The Provider | HELENA |
| Zip Code Of The Provider | 596014915 |
| State Code Of The Provider | MT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 101 |
| Number Of Services | 1474 |
| Number Of Medicare Beneficiaries | 337 |
| Total Submitted Charge Amount | 721984 |
| Total Medicare Allowed Amount | 172652.92 |
| Total Medicare Payment Amount | 129069.74 |
| Total Medicare Standardized Payment Amount | 126207.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 207 |
| Number Of Medicare Beneficiaries With Drug Services | 51 |
| Total Drug Submitted ChargeAmount | 34425 |
| Total Drug Medicare AllowedAmount | 13595.77 |
| Total Drug Medicare PaymentAmount | 9930.73 |
| Total Drug Medicare Standardized Payment Amount | 9930.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 99 |
| Number Of Medical Services | 1267 |
| Number Of Medicare Beneficiaries With Medical Services | 337 |
| Total Medical Submitted Charge Amount | 687559 |
| Total Medical Medicare Allowed Amount | 159057.15 |
| Total Medical Medicare Payment Amount | 119139.01 |
| Total Medical Medicare Standardized Payment Amount | 116276.35 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 29 |
| Number Of Beneficiaries Age 65 to 74 | 164 |
| Number Of Beneficiaries Age 75 to 84 | 107 |
| Number Of Beneficiaries Age Greater 84 | 37 |
| Number Of Female Beneficiaries | 215 |
| Number Of Male Beneficiaries | 122 |
| Number Of Non Hispanic White Beneficiaries | 326 |
| Number Of Black or African American Beneficiaries | 0 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 308 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 29 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 33 |
| Percent Of With Hypertension | 46 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 74 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9721 |