| National Provider Identifier [NPI]: | 1750475240 |
| Last Name Of The Provider | VICKARYOUS |
| First Name Of The Provider | JOSEPH |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 531 BALD EAGLE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | MARCO ISLAND |
| Zip Code Of The Provider | 341452700 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 85 |
| Number Of Services | 11102 |
| Number Of Medicare Beneficiaries | 874 |
| Total Submitted Charge Amount | 611963.19 |
| Total Medicare Allowed Amount | 595534.08 |
| Total Medicare Payment Amount | 448516.46 |
| Total Medicare Standardized Payment Amount | 431514.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 1116 |
| Number Of Medicare Beneficiaries With Drug Services | 348 |
| Total Drug Submitted ChargeAmount | 18903.42 |
| Total Drug Medicare AllowedAmount | 12303.88 |
| Total Drug Medicare PaymentAmount | 11474.25 |
| Total Drug Medicare Standardized Payment Amount | 11474.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 72 |
| Number Of Medical Services | 9986 |
| Number Of Medicare Beneficiaries With Medical Services | 874 |
| Total Medical Submitted Charge Amount | 593059.77 |
| Total Medical Medicare Allowed Amount | 583230.2 |
| Total Medical Medicare Payment Amount | 437042.21 |
| Total Medical Medicare Standardized Payment Amount | 420040.69 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 32 |
| Number Of Beneficiaries Age 65 to 74 | 398 |
| Number Of Beneficiaries Age 75 to 84 | 320 |
| Number Of Beneficiaries Age Greater 84 | 124 |
| Number Of Female Beneficiaries | 449 |
| Number Of Male Beneficiaries | 425 |
| Number Of Non Hispanic White Beneficiaries | 850 |
| 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 | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 845 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 29 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 0.9945 |