| National Provider Identifier [NPI]: | 1427053685 |
| Last Name Of The Provider | VANDYKE |
| First Name Of The Provider | TAMARA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6490 S. MCCARRAN BLVD |
| Street Address 2 Of The Provider | STE D-38 |
| City Of The Provider | RENO |
| Zip Code Of The Provider | 89509 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 8072 |
| Number Of Medicare Beneficiaries | 1188 |
| Total Submitted Charge Amount | 436777.72 |
| Total Medicare Allowed Amount | 296878.25 |
| Total Medicare Payment Amount | 203914.63 |
| Total Medicare Standardized Payment Amount | 225822.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 150 |
| Number Of Medicare Beneficiaries With Drug Services | 44 |
| Total Drug Submitted ChargeAmount | 614.22 |
| Total Drug Medicare AllowedAmount | 325.6 |
| Total Drug Medicare PaymentAmount | 219.14 |
| Total Drug Medicare Standardized Payment Amount | 219.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 7922 |
| Number Of Medicare Beneficiaries With Medical Services | 1188 |
| Total Medical Submitted Charge Amount | 436163.5 |
| Total Medical Medicare Allowed Amount | 296552.65 |
| Total Medical Medicare Payment Amount | 203695.49 |
| Total Medical Medicare Standardized Payment Amount | 225603.83 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 54 |
| Number Of Beneficiaries Age 65 to 74 | 603 |
| Number Of Beneficiaries Age 75 to 84 | 410 |
| Number Of Beneficiaries Age Greater 84 | 121 |
| Number Of Female Beneficiaries | 656 |
| Number Of Male Beneficiaries | 532 |
| Number Of Non Hispanic White Beneficiaries | 1122 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1142 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 46 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.8512 |