| National Provider Identifier [NPI]: | 1619069804 |
| Last Name Of The Provider | EVANCHO |
| First Name Of The Provider | WAYNE |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1380 NE MIAMI GARDENS DRIVE |
| Street Address 2 Of The Provider | SUITE 285 |
| City Of The Provider | NORTH MIAMI BEACH |
| Zip Code Of The Provider | 33179 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 12 |
| Number Of Services | 2743 |
| Number Of Medicare Beneficiaries | 617 |
| Total Submitted Charge Amount | 249216 |
| Total Medicare Allowed Amount | 192547.75 |
| Total Medicare Payment Amount | 149635.99 |
| Total Medicare Standardized Payment Amount | 148305.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 39 |
| Number Of Medicare Beneficiaries With Drug Services | 39 |
| Total Drug Submitted ChargeAmount | 975 |
| Total Drug Medicare AllowedAmount | 600.6 |
| Total Drug Medicare PaymentAmount | 588.51 |
| Total Drug Medicare Standardized Payment Amount | 588.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 11 |
| Number Of Medical Services | 2704 |
| Number Of Medicare Beneficiaries With Medical Services | 617 |
| Total Medical Submitted Charge Amount | 248241 |
| Total Medical Medicare Allowed Amount | 191947.15 |
| Total Medical Medicare Payment Amount | 149047.48 |
| Total Medical Medicare Standardized Payment Amount | 147717.24 |
| Average Age Of Beneficiaries | 81 |
| Number Of Beneficiaries Age Less65 | 49 |
| Number Of Beneficiaries Age 65 to 74 | 124 |
| Number Of Beneficiaries Age 75 to 84 | 182 |
| Number Of Beneficiaries Age Greater 84 | 262 |
| Number Of Female Beneficiaries | 425 |
| Number Of Male Beneficiaries | 192 |
| Number Of Non Hispanic White Beneficiaries | 402 |
| Number Of Black or African American Beneficiaries | 103 |
| 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 | 291 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 326 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 56 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 49 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 73 |
| Percent Of With Osteoporosis | 25 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 66 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 24 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.2894 |