| National Provider Identifier [NPI]: | 1801862974 |
| Last Name Of The Provider | DEVAN |
| First Name Of The Provider | VICTORIA |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 SCENERY DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | STATE COLLEGE |
| Zip Code Of The Provider | 16801 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 1077 |
| Number Of Medicare Beneficiaries | 419 |
| Total Submitted Charge Amount | 145979 |
| Total Medicare Allowed Amount | 73724.74 |
| Total Medicare Payment Amount | 55697.84 |
| Total Medicare Standardized Payment Amount | 58075.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 153 |
| Number Of Medicare Beneficiaries With Drug Services | 101 |
| Total Drug Submitted ChargeAmount | 6614 |
| Total Drug Medicare AllowedAmount | 3086.82 |
| Total Drug Medicare PaymentAmount | 2994.09 |
| Total Drug Medicare Standardized Payment Amount | 2994.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 924 |
| Number Of Medicare Beneficiaries With Medical Services | 419 |
| Total Medical Submitted Charge Amount | 139365 |
| Total Medical Medicare Allowed Amount | 70637.92 |
| Total Medical Medicare Payment Amount | 52703.75 |
| Total Medical Medicare Standardized Payment Amount | 55080.92 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 75 |
| Number Of Beneficiaries Age 65 to 74 | 149 |
| Number Of Beneficiaries Age 75 to 84 | 94 |
| Number Of Beneficiaries Age Greater 84 | 101 |
| Number Of Female Beneficiaries | 305 |
| Number Of Male Beneficiaries | 114 |
| 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 | 342 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 77 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3028 |