| National Provider Identifier [NPI]: | 1750369211 |
| Last Name Of The Provider | VANDERHEIDEN |
| First Name Of The Provider | SCOTT |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 19020 33RD AVE W |
| Street Address 2 Of The Provider | STE 210 |
| City Of The Provider | LYNNWOOD |
| Zip Code Of The Provider | 980364746 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 131 |
| Number Of Services | 6057 |
| Number Of Medicare Beneficiaries | 3816 |
| Total Submitted Charge Amount | 820740.02 |
| Total Medicare Allowed Amount | 185312.87 |
| Total Medicare Payment Amount | 134943.05 |
| Total Medicare Standardized Payment Amount | 134192.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1055 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 285.7 |
| Total Drug Medicare AllowedAmount | 230.27 |
| Total Drug Medicare PaymentAmount | 180.52 |
| Total Drug Medicare Standardized Payment Amount | 180.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 129 |
| Number Of Medical Services | 5002 |
| Number Of Medicare Beneficiaries With Medical Services | 3816 |
| Total Medical Submitted Charge Amount | 820454.32 |
| Total Medical Medicare Allowed Amount | 185082.6 |
| Total Medical Medicare Payment Amount | 134762.53 |
| Total Medical Medicare Standardized Payment Amount | 134012.14 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 679 |
| Number Of Beneficiaries Age 65 to 74 | 1137 |
| Number Of Beneficiaries Age 75 to 84 | 1162 |
| Number Of Beneficiaries Age Greater 84 | 838 |
| Number Of Female Beneficiaries | 2168 |
| Number Of Male Beneficiaries | 1648 |
| Number Of Non Hispanic White Beneficiaries | 3356 |
| Number Of Black or African American Beneficiaries | 101 |
| Number Of AsianPacific Islander Beneficiaries | 139 |
| Number Of Hispanic Beneficiaries | 100 |
| Number Of American Indian Alaska Native Beneficiaries | 61 |
| Number Of Beneficiaries With Race Not Else where Classified | 59 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2729 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1087 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7744 |