| National Provider Identifier [NPI]: | 1700983343 |
| Last Name Of The Provider | VADEN |
| First Name Of The Provider | REGGIE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1241 W STADIUM BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | JEFFERSON CITY |
| Zip Code Of The Provider | 651096023 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Colorectal Surgery (formerly proctology) |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 278 |
| Number Of Medicare Beneficiaries | 149 |
| Total Submitted Charge Amount | 141213 |
| Total Medicare Allowed Amount | 61136.89 |
| Total Medicare Payment Amount | 47316.87 |
| Total Medicare Standardized Payment Amount | 51160.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 73 |
| Number Of Medical Services | 278 |
| Number Of Medicare Beneficiaries With Medical Services | 149 |
| Total Medical Submitted Charge Amount | 141213 |
| Total Medical Medicare Allowed Amount | 61136.89 |
| Total Medical Medicare Payment Amount | 47316.87 |
| Total Medical Medicare Standardized Payment Amount | 51160.22 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 65 |
| Number Of Beneficiaries Age 75 to 84 | 40 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 83 |
| Number Of Male Beneficiaries | 66 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 125 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 24 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2301 |