| National Provider Identifier [NPI]: | 1134133424 |
| Last Name Of The Provider | SAMAVEDI |
| First Name Of The Provider | VANDITA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 14410 SE PETROVITSKY RD |
| Street Address 2 Of The Provider | STE 104 |
| City Of The Provider | RENTON |
| Zip Code Of The Provider | 980588900 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 636 |
| Number Of Medicare Beneficiaries | 266 |
| Total Submitted Charge Amount | 135050.4 |
| Total Medicare Allowed Amount | 55813.75 |
| Total Medicare Payment Amount | 35108.25 |
| Total Medicare Standardized Payment Amount | 32772.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 47 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 615.4 |
| Total Drug Medicare AllowedAmount | 448.39 |
| Total Drug Medicare PaymentAmount | 417.71 |
| Total Drug Medicare Standardized Payment Amount | 417.71 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 589 |
| Number Of Medicare Beneficiaries With Medical Services | 266 |
| Total Medical Submitted Charge Amount | 134435 |
| Total Medical Medicare Allowed Amount | 55365.36 |
| Total Medical Medicare Payment Amount | 34690.54 |
| Total Medical Medicare Standardized Payment Amount | 32354.31 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 100 |
| Number Of Beneficiaries Age 75 to 84 | 100 |
| Number Of Beneficiaries Age Greater 84 | 41 |
| Number Of Female Beneficiaries | 190 |
| Number Of Male Beneficiaries | 76 |
| Number Of Non Hispanic White Beneficiaries | 189 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 53 |
| 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 | 199 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 67 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 35 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0298 |