| National Provider Identifier [NPI]: | 1245259761 |
| Last Name Of The Provider | WHITE |
| First Name Of The Provider | VINCENT |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | O.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 15230 BURBANK BLVD |
| Street Address 2 Of The Provider | #109 |
| City Of The Provider | SHERMAN OAKS |
| Zip Code Of The Provider | 914113534 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Optometry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 15 |
| Number Of Services | 1155 |
| Number Of Medicare Beneficiaries | 277 |
| Total Submitted Charge Amount | 181805 |
| Total Medicare Allowed Amount | 108951.87 |
| Total Medicare Payment Amount | 83860.02 |
| Total Medicare Standardized Payment Amount | 75819.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 1155 |
| Number Of Medicare Beneficiaries With Medical Services | 277 |
| Total Medical Submitted Charge Amount | 181805 |
| Total Medical Medicare Allowed Amount | 108951.87 |
| Total Medical Medicare Payment Amount | 83860.02 |
| Total Medical Medicare Standardized Payment Amount | 75819.09 |
| Average Age Of Beneficiaries | 60 |
| Number Of Beneficiaries Age Less65 | 158 |
| Number Of Beneficiaries Age 65 to 74 | 73 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 125 |
| Number Of Male Beneficiaries | 152 |
| Number Of Non Hispanic White Beneficiaries | 160 |
| Number Of Black or African American Beneficiaries | 52 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 39 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 60 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 217 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 50 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 56 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.5301 |