| National Provider Identifier [NPI]: | 1780794222 |
| Last Name Of The Provider | VAVASSEUR |
| First Name Of The Provider | CHANTEE |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7011 SOUTHWEST FWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770742007 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 10 |
| Number Of Services | 721 |
| Number Of Medicare Beneficiaries | 149 |
| Total Submitted Charge Amount | 57756 |
| Total Medicare Allowed Amount | 32237.18 |
| Total Medicare Payment Amount | 20512.58 |
| Total Medicare Standardized Payment Amount | 20386.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 174 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 6828 |
| Total Drug Medicare AllowedAmount | 3417.68 |
| Total Drug Medicare PaymentAmount | 2498.92 |
| Total Drug Medicare Standardized Payment Amount | 2498.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 8 |
| Number Of Medical Services | 547 |
| Number Of Medicare Beneficiaries With Medical Services | 149 |
| Total Medical Submitted Charge Amount | 50928 |
| Total Medical Medicare Allowed Amount | 28819.5 |
| Total Medical Medicare Payment Amount | 18013.66 |
| Total Medical Medicare Standardized Payment Amount | 17887.69 |
| Average Age Of Beneficiaries | 51 |
| Number Of Beneficiaries Age Less65 | 127 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 77 |
| Number Of Male Beneficiaries | 72 |
| Number Of Non Hispanic White Beneficiaries | 37 |
| Number Of Black or African American Beneficiaries | 86 |
| 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 | 47 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 102 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 56 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 30 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 64 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1023 |