| National Provider Identifier [NPI]: | 1861488314 |
| Last Name Of The Provider | VACCAREZZA |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6240 MONTROSE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROCKVILLE |
| Zip Code Of The Provider | 208524119 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 4897 |
| Number Of Medicare Beneficiaries | 568 |
| Total Submitted Charge Amount | 463758.5 |
| Total Medicare Allowed Amount | 319212.98 |
| Total Medicare Payment Amount | 242762.19 |
| Total Medicare Standardized Payment Amount | 222733.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2188 |
| Number Of Medicare Beneficiaries With Drug Services | 44 |
| Total Drug Submitted ChargeAmount | 30808 |
| Total Drug Medicare AllowedAmount | 25126.53 |
| Total Drug Medicare PaymentAmount | 19772.34 |
| Total Drug Medicare Standardized Payment Amount | 19772.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 2709 |
| Number Of Medicare Beneficiaries With Medical Services | 568 |
| Total Medical Submitted Charge Amount | 432950.5 |
| Total Medical Medicare Allowed Amount | 294086.45 |
| Total Medical Medicare Payment Amount | 222989.85 |
| Total Medical Medicare Standardized Payment Amount | 202961.09 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 89 |
| Number Of Beneficiaries Age 65 to 74 | 161 |
| Number Of Beneficiaries Age 75 to 84 | 190 |
| Number Of Beneficiaries Age Greater 84 | 128 |
| Number Of Female Beneficiaries | 258 |
| Number Of Male Beneficiaries | 310 |
| Number Of Non Hispanic White Beneficiaries | 336 |
| Number Of Black or African American Beneficiaries | 112 |
| Number Of AsianPacific Islander Beneficiaries | 59 |
| Number Of Hispanic Beneficiaries | 40 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 423 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 145 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 3.1809 |