| National Provider Identifier [NPI]: | 1427138015 |
| Last Name Of The Provider | LANDREVILLE |
| First Name Of The Provider | WENDY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M D |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 290 REDWOOD SHORES PKWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | REDWOOD CITY |
| Zip Code Of The Provider | 940651173 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 239 |
| Number Of Medicare Beneficiaries | 97 |
| Total Submitted Charge Amount | 40392 |
| Total Medicare Allowed Amount | 21419.86 |
| Total Medicare Payment Amount | 16461.14 |
| Total Medicare Standardized Payment Amount | 14176.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 37 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 1366 |
| Total Drug Medicare AllowedAmount | 1215 |
| Total Drug Medicare PaymentAmount | 1177.98 |
| Total Drug Medicare Standardized Payment Amount | 1177.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 202 |
| Number Of Medicare Beneficiaries With Medical Services | 96 |
| Total Medical Submitted Charge Amount | 39026 |
| Total Medical Medicare Allowed Amount | 20204.86 |
| Total Medical Medicare Payment Amount | 15283.16 |
| Total Medical Medicare Standardized Payment Amount | 12998.34 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 61 |
| Number Of Beneficiaries Age 75 to 84 | 20 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 66 |
| Number Of Male Beneficiaries | 31 |
| Number Of Non Hispanic White Beneficiaries | 82 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 97 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 0 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7244 |