| National Provider Identifier [NPI]: | 1740205715 |
| Last Name Of The Provider | VEGA |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1417 W BEVERLY BLVD |
| Street Address 2 Of The Provider | 104 |
| City Of The Provider | MONTEBELLO |
| Zip Code Of The Provider | 906404123 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 78 |
| Number Of Services | 3032 |
| Number Of Medicare Beneficiaries | 442 |
| Total Submitted Charge Amount | 352229.1 |
| Total Medicare Allowed Amount | 229362.73 |
| Total Medicare Payment Amount | 171940.01 |
| Total Medicare Standardized Payment Amount | 156005.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 270 |
| Number Of Medicare Beneficiaries With Drug Services | 80 |
| Total Drug Submitted ChargeAmount | 10756 |
| Total Drug Medicare AllowedAmount | 6279.41 |
| Total Drug Medicare PaymentAmount | 4922.62 |
| Total Drug Medicare Standardized Payment Amount | 4922.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 2762 |
| Number Of Medicare Beneficiaries With Medical Services | 442 |
| Total Medical Submitted Charge Amount | 341473.1 |
| Total Medical Medicare Allowed Amount | 223083.32 |
| Total Medical Medicare Payment Amount | 167017.39 |
| Total Medical Medicare Standardized Payment Amount | 151082.63 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 49 |
| Number Of Beneficiaries Age 65 to 74 | 123 |
| Number Of Beneficiaries Age 75 to 84 | 160 |
| Number Of Beneficiaries Age Greater 84 | 110 |
| Number Of Female Beneficiaries | 312 |
| Number Of Male Beneficiaries | 130 |
| Number Of Non Hispanic White Beneficiaries | 123 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 294 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 189 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 253 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 60 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.6961 |