| National Provider Identifier [NPI]: | 1639165467 |
| Last Name Of The Provider | VINCI |
| First Name Of The Provider | SAMUEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4115 FAIRVIEW AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | DOWNERS GROVE |
| Zip Code Of The Provider | 605152268 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 2177 |
| Number Of Medicare Beneficiaries | 694 |
| Total Submitted Charge Amount | 361411 |
| Total Medicare Allowed Amount | 132852.11 |
| Total Medicare Payment Amount | 93695.12 |
| Total Medicare Standardized Payment Amount | 88500.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 181 |
| Number Of Medicare Beneficiaries With Drug Services | 55 |
| Total Drug Submitted ChargeAmount | 2019 |
| Total Drug Medicare AllowedAmount | 633.71 |
| Total Drug Medicare PaymentAmount | 474.6 |
| Total Drug Medicare Standardized Payment Amount | 474.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 1996 |
| Number Of Medicare Beneficiaries With Medical Services | 694 |
| Total Medical Submitted Charge Amount | 359392 |
| Total Medical Medicare Allowed Amount | 132218.4 |
| Total Medical Medicare Payment Amount | 93220.52 |
| Total Medical Medicare Standardized Payment Amount | 88025.78 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 335 |
| Number Of Beneficiaries Age 75 to 84 | 200 |
| Number Of Beneficiaries Age Greater 84 | 108 |
| Number Of Female Beneficiaries | 445 |
| Number Of Male Beneficiaries | 249 |
| Number Of Non Hispanic White Beneficiaries | 643 |
| Number Of Black or African American Beneficiaries | 14 |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 649 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 45 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.139 |