| National Provider Identifier [NPI]: | 1902891351 |
| Last Name Of The Provider | VANCE |
| First Name Of The Provider | PHILIP |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1708 YAKIMA AVE |
| Street Address 2 Of The Provider | SUITE #50 |
| City Of The Provider | TACOMA |
| Zip Code Of The Provider | 984055307 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 1675 |
| Number Of Medicare Beneficiaries | 221 |
| Total Submitted Charge Amount | 153824.5 |
| Total Medicare Allowed Amount | 106876.96 |
| Total Medicare Payment Amount | 75987.31 |
| Total Medicare Standardized Payment Amount | 76306.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 144 |
| Number Of Medicare Beneficiaries With Drug Services | 110 |
| Total Drug Submitted ChargeAmount | 4281 |
| Total Drug Medicare AllowedAmount | 2935.7 |
| Total Drug Medicare PaymentAmount | 2852.91 |
| Total Drug Medicare Standardized Payment Amount | 2852.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 1531 |
| Number Of Medicare Beneficiaries With Medical Services | 221 |
| Total Medical Submitted Charge Amount | 149543.5 |
| Total Medical Medicare Allowed Amount | 103941.26 |
| Total Medical Medicare Payment Amount | 73134.4 |
| Total Medical Medicare Standardized Payment Amount | 73453.86 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 98 |
| Number Of Beneficiaries Age 75 to 84 | 78 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 113 |
| Number Of Male Beneficiaries | 108 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9311 |