| National Provider Identifier [NPI]: | 1003132978 |
| Last Name Of The Provider | VANZANDT |
| First Name Of The Provider | BRYAN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4625 S WESTERN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | OKLAHOMA CITY |
| Zip Code Of The Provider | 731093831 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 241 |
| Number Of Services | 4006 |
| Number Of Medicare Beneficiaries | 1883 |
| Total Submitted Charge Amount | 764786 |
| Total Medicare Allowed Amount | 141058.7 |
| Total Medicare Payment Amount | 108094.89 |
| Total Medicare Standardized Payment Amount | 116622.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 920 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 960 |
| Total Drug Medicare AllowedAmount | 234.72 |
| Total Drug Medicare PaymentAmount | 184.02 |
| Total Drug Medicare Standardized Payment Amount | 184.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 239 |
| Number Of Medical Services | 3086 |
| Number Of Medicare Beneficiaries With Medical Services | 1883 |
| Total Medical Submitted Charge Amount | 763826 |
| Total Medical Medicare Allowed Amount | 140823.98 |
| Total Medical Medicare Payment Amount | 107910.87 |
| Total Medical Medicare Standardized Payment Amount | 116438.02 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 294 |
| Number Of Beneficiaries Age 65 to 74 | 683 |
| Number Of Beneficiaries Age 75 to 84 | 591 |
| Number Of Beneficiaries Age Greater 84 | 315 |
| Number Of Female Beneficiaries | 1071 |
| Number Of Male Beneficiaries | 812 |
| Number Of Non Hispanic White Beneficiaries | 1420 |
| Number Of Black or African American Beneficiaries | 111 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 313 |
| Number Of American Indian Alaska Native Beneficiaries | 23 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1449 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 434 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.9596 |