| National Provider Identifier [NPI]: | 1922270735 |
| Last Name Of The Provider | DEENADAYALU |
| First Name Of The Provider | VIJU |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1111 NE 99TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PORTLAND |
| Zip Code Of The Provider | 972209428 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Gastroenterology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 3045 |
| Number Of Medicare Beneficiaries | 189 |
| Total Submitted Charge Amount | 257438 |
| Total Medicare Allowed Amount | 57429.45 |
| Total Medicare Payment Amount | 44315.56 |
| Total Medicare Standardized Payment Amount | 44452.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 2639 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 19347 |
| Total Drug Medicare AllowedAmount | 9426.85 |
| Total Drug Medicare PaymentAmount | 7392.27 |
| Total Drug Medicare Standardized Payment Amount | 7392.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 43 |
| Number Of Medical Services | 406 |
| Number Of Medicare Beneficiaries With Medical Services | 189 |
| Total Medical Submitted Charge Amount | 238091 |
| Total Medical Medicare Allowed Amount | 48002.6 |
| Total Medical Medicare Payment Amount | 36923.29 |
| Total Medical Medicare Standardized Payment Amount | 37060.48 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 81 |
| Number Of Beneficiaries Age 75 to 84 | 37 |
| Number Of Beneficiaries Age Greater 84 | 14 |
| Number Of Female Beneficiaries | 113 |
| Number Of Male Beneficiaries | 76 |
| Number Of Non Hispanic White Beneficiaries | 163 |
| 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 | 136 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 53 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1932 |