| National Provider Identifier [NPI]: | 1124210281 |
| Last Name Of The Provider | VANCE |
| First Name Of The Provider | SUSHMA |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1978 ROCKLEDGE BLVD |
| Street Address 2 Of The Provider | SUITE 105 |
| City Of The Provider | ROCKLEDGE |
| Zip Code Of The Provider | 329553722 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 14879 |
| Number Of Medicare Beneficiaries | 888 |
| Total Submitted Charge Amount | 8199202.49 |
| Total Medicare Allowed Amount | 4757979.9 |
| Total Medicare Payment Amount | 3675047.55 |
| Total Medicare Standardized Payment Amount | 3676897.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 8003 |
| Number Of Medicare Beneficiaries With Drug Services | 526 |
| Total Drug Submitted ChargeAmount | 6371445.49 |
| Total Drug Medicare AllowedAmount | 4167723.87 |
| Total Drug Medicare PaymentAmount | 3233723.51 |
| Total Drug Medicare Standardized Payment Amount | 3233723.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 6876 |
| Number Of Medicare Beneficiaries With Medical Services | 888 |
| Total Medical Submitted Charge Amount | 1827757 |
| Total Medical Medicare Allowed Amount | 590256.03 |
| Total Medical Medicare Payment Amount | 441324.04 |
| Total Medical Medicare Standardized Payment Amount | 443173.67 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 63 |
| Number Of Beneficiaries Age 65 to 74 | 293 |
| Number Of Beneficiaries Age 75 to 84 | 297 |
| Number Of Beneficiaries Age Greater 84 | 235 |
| Number Of Female Beneficiaries | 526 |
| Number Of Male Beneficiaries | 362 |
| Number Of Non Hispanic White Beneficiaries | 755 |
| Number Of Black or African American Beneficiaries | 42 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 63 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 803 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 85 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5666 |