National Provider Identifier [NPI]: |
1932117116 |
Last Name Of The Provider |
VANDEVORT |
First Name Of The Provider |
KURT |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
401 OLD SAN FRANCISCO RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SUNNYVALE |
Zip Code Of The Provider |
940866387 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
1191 |
Number Of Medicare Beneficiaries |
431 |
Total Submitted Charge Amount |
242489 |
Total Medicare Allowed Amount |
114752.37 |
Total Medicare Payment Amount |
80273.18 |
Total Medicare Standardized Payment Amount |
69157.89 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
125 |
Number Of Medicare Beneficiaries With Drug Services |
102 |
Total Drug Submitted ChargeAmount |
7450 |
Total Drug Medicare AllowedAmount |
7033.11 |
Total Drug Medicare PaymentAmount |
6881.14 |
Total Drug Medicare Standardized Payment Amount |
6881.14 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
1066 |
Number Of Medicare Beneficiaries With Medical Services |
430 |
Total Medical Submitted Charge Amount |
235039 |
Total Medical Medicare Allowed Amount |
107719.26 |
Total Medical Medicare Payment Amount |
73392.04 |
Total Medical Medicare Standardized Payment Amount |
62276.75 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
177 |
Number Of Beneficiaries Age 75 to 84 |
159 |
Number Of Beneficiaries Age Greater 84 |
74 |
Number Of Female Beneficiaries |
168 |
Number Of Male Beneficiaries |
263 |
Number Of Non Hispanic White Beneficiaries |
324 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
53 |
Number Of Hispanic Beneficiaries |
34 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
396 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
35 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
5 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
19 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9148 |