| National Provider Identifier [NPI]: | 1316250558 |
| Last Name Of The Provider | VANG |
| First Name Of The Provider | AMELIA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2001 BLAISDELL AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MINNEAPOLIS |
| Zip Code Of The Provider | 554042414 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 540 |
| Number Of Medicare Beneficiaries | 86 |
| Total Submitted Charge Amount | 37982.56 |
| Total Medicare Allowed Amount | 17038.25 |
| Total Medicare Payment Amount | 12091.98 |
| Total Medicare Standardized Payment Amount | 14480.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 176 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 923.6 |
| Total Drug Medicare AllowedAmount | 592.7 |
| Total Drug Medicare PaymentAmount | 565.46 |
| Total Drug Medicare Standardized Payment Amount | 565.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 364 |
| Number Of Medicare Beneficiaries With Medical Services | 86 |
| Total Medical Submitted Charge Amount | 37058.96 |
| Total Medical Medicare Allowed Amount | 16445.55 |
| Total Medical Medicare Payment Amount | 11526.52 |
| Total Medical Medicare Standardized Payment Amount | 13914.79 |
| Average Age Of Beneficiaries | 55 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 16 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 67 |
| Number Of Male Beneficiaries | 19 |
| Number Of Non Hispanic White Beneficiaries | 55 |
| 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 | 23 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 63 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 23 |
| Percent Of With Hypertension | 34 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 24 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 20 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9845 |