| National Provider Identifier [NPI]: | 1912122680 |
| Last Name Of The Provider | VANDENBERG |
| First Name Of The Provider | GARY |
| 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 | 9834 GENESEE AVE |
| Street Address 2 Of The Provider | SUITE 326 |
| City Of The Provider | LA JOLLA |
| Zip Code Of The Provider | 920371223 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Obstetrics/Gynecology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 2023 |
| Number Of Medicare Beneficiaries | 257 |
| Total Submitted Charge Amount | 275434.33 |
| Total Medicare Allowed Amount | 158112.38 |
| Total Medicare Payment Amount | 123128.18 |
| Total Medicare Standardized Payment Amount | 119756.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 447 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 37313.49 |
| Total Drug Medicare AllowedAmount | 27441.24 |
| Total Drug Medicare PaymentAmount | 20957.38 |
| Total Drug Medicare Standardized Payment Amount | 20957.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 1576 |
| Number Of Medicare Beneficiaries With Medical Services | 257 |
| Total Medical Submitted Charge Amount | 238120.84 |
| Total Medical Medicare Allowed Amount | 130671.14 |
| Total Medical Medicare Payment Amount | 102170.8 |
| Total Medical Medicare Standardized Payment Amount | 98799.56 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 132 |
| Number Of Beneficiaries Age 75 to 84 | 84 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 257 |
| Number Of Male Beneficiaries | 0 |
| Number Of Non Hispanic White Beneficiaries | 238 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| 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 | 7 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 6 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 15 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 42 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 22 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7931 |