| National Provider Identifier [NPI]: | 1174567861 |
| Last Name Of The Provider | VANDERKOOI |
| First Name Of The Provider | RUTH |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8350 WCR 13 UNIT 160 |
| Street Address 2 Of The Provider | |
| City Of The Provider | FIRESTONE |
| Zip Code Of The Provider | 805046803 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 292 |
| Number Of Medicare Beneficiaries | 69 |
| Total Submitted Charge Amount | 19114.5 |
| Total Medicare Allowed Amount | 16864.55 |
| Total Medicare Payment Amount | 11405.38 |
| Total Medicare Standardized Payment Amount | 11494.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 28 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 763.5 |
| Total Drug Medicare AllowedAmount | 558.25 |
| Total Drug Medicare PaymentAmount | 543.6 |
| Total Drug Medicare Standardized Payment Amount | 543.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 264 |
| Number Of Medicare Beneficiaries With Medical Services | 69 |
| Total Medical Submitted Charge Amount | 18351 |
| Total Medical Medicare Allowed Amount | 16306.3 |
| Total Medical Medicare Payment Amount | 10861.78 |
| Total Medical Medicare Standardized Payment Amount | 10950.68 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 40 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 40 |
| Number Of Male Beneficiaries | 29 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 58 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 11 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 46 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9745 |