| National Provider Identifier [NPI]: | 1912938234 |
| Last Name Of The Provider | VANCE |
| First Name Of The Provider | JASON |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6480 PENTZ RD |
| Street Address 2 Of The Provider | SUITE B |
| City Of The Provider | PARADISE |
| Zip Code Of The Provider | 959693672 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 80 |
| Number Of Services | 13935 |
| Number Of Medicare Beneficiaries | 1659 |
| Total Submitted Charge Amount | 766404.27 |
| Total Medicare Allowed Amount | 734641.62 |
| Total Medicare Payment Amount | 567415.03 |
| Total Medicare Standardized Payment Amount | 553622.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 21 |
| Number Of Drug Services | 6409 |
| Number Of Medicare Beneficiaries With Drug Services | 844 |
| Total Drug Submitted ChargeAmount | 145032.15 |
| Total Drug Medicare AllowedAmount | 117425.05 |
| Total Drug Medicare PaymentAmount | 101264.79 |
| Total Drug Medicare Standardized Payment Amount | 101264.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 7526 |
| Number Of Medicare Beneficiaries With Medical Services | 1655 |
| Total Medical Submitted Charge Amount | 621372.12 |
| Total Medical Medicare Allowed Amount | 617216.57 |
| Total Medical Medicare Payment Amount | 466150.24 |
| Total Medical Medicare Standardized Payment Amount | 452357.84 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 127 |
| Number Of Beneficiaries Age 65 to 74 | 567 |
| Number Of Beneficiaries Age 75 to 84 | 533 |
| Number Of Beneficiaries Age Greater 84 | 432 |
| Number Of Female Beneficiaries | 1011 |
| Number Of Male Beneficiaries | 648 |
| Number Of Non Hispanic White Beneficiaries | 1599 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1467 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 192 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.3437 |