| National Provider Identifier [NPI]: | 1588699466 |
| Last Name Of The Provider | VANDEL |
| First Name Of The Provider | JERRY |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2911 MEDICAL ARTS STREET |
| Street Address 2 Of The Provider | BLDG 10 |
| City Of The Provider | AUSTIN |
| Zip Code Of The Provider | 787053302 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 2483 |
| Number Of Medicare Beneficiaries | 585 |
| Total Submitted Charge Amount | 150423.23 |
| Total Medicare Allowed Amount | 134116.12 |
| Total Medicare Payment Amount | 102605.31 |
| Total Medicare Standardized Payment Amount | 103437.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 198 |
| Number Of Medicare Beneficiaries With Drug Services | 164 |
| Total Drug Submitted ChargeAmount | 5753.4 |
| Total Drug Medicare AllowedAmount | 5363.87 |
| Total Drug Medicare PaymentAmount | 5140 |
| Total Drug Medicare Standardized Payment Amount | 5140 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 2285 |
| Number Of Medicare Beneficiaries With Medical Services | 585 |
| Total Medical Submitted Charge Amount | 144669.83 |
| Total Medical Medicare Allowed Amount | 128752.25 |
| Total Medical Medicare Payment Amount | 97465.31 |
| Total Medical Medicare Standardized Payment Amount | 98297.68 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 354 |
| Number Of Beneficiaries Age 75 to 84 | 172 |
| Number Of Beneficiaries Age Greater 84 | 47 |
| Number Of Female Beneficiaries | 270 |
| Number Of Male Beneficiaries | 315 |
| Number Of Non Hispanic White Beneficiaries | 514 |
| Number Of Black or African American Beneficiaries | 25 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 5 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.8056 |