| National Provider Identifier [NPI]: | 1043264781 |
| Last Name Of The Provider | DEVEREAUX |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11100 WARNER AVE |
| Street Address 2 Of The Provider | STE 100 |
| City Of The Provider | FOUNTAIN VALLEY |
| Zip Code Of The Provider | 92708 |
| 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 | 64 |
| Number Of Services | 2713 |
| Number Of Medicare Beneficiaries | 340 |
| Total Submitted Charge Amount | 216745 |
| Total Medicare Allowed Amount | 160227.21 |
| Total Medicare Payment Amount | 113339.34 |
| Total Medicare Standardized Payment Amount | 105966.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 171 |
| Number Of Medicare Beneficiaries With Drug Services | 133 |
| Total Drug Submitted ChargeAmount | 3173 |
| Total Drug Medicare AllowedAmount | 2301.18 |
| Total Drug Medicare PaymentAmount | 2250.61 |
| Total Drug Medicare Standardized Payment Amount | 2250.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 2542 |
| Number Of Medicare Beneficiaries With Medical Services | 340 |
| Total Medical Submitted Charge Amount | 213572 |
| Total Medical Medicare Allowed Amount | 157926.03 |
| Total Medical Medicare Payment Amount | 111088.73 |
| Total Medical Medicare Standardized Payment Amount | 103715.73 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 20 |
| Number Of Beneficiaries Age 65 to 74 | 135 |
| Number Of Beneficiaries Age 75 to 84 | 131 |
| Number Of Beneficiaries Age Greater 84 | 54 |
| Number Of Female Beneficiaries | 175 |
| Number Of Male Beneficiaries | 165 |
| Number Of Non Hispanic White Beneficiaries | 289 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 320 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 20 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1219 |