| National Provider Identifier [NPI]: | 1508076548 |
| Last Name Of The Provider | VATCA |
| First Name Of The Provider | MIHAELA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | MEDICAL CENTER BLVD |
| Street Address 2 Of The Provider | DEPARTMENT OF HEMATOLOGY AND ONCOLOGY |
| City Of The Provider | WINSTON SALEM |
| Zip Code Of The Provider | 271570001 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 37824 |
| Number Of Medicare Beneficiaries | 280 |
| Total Submitted Charge Amount | 773344.04 |
| Total Medicare Allowed Amount | 312482.58 |
| Total Medicare Payment Amount | 241003.52 |
| Total Medicare Standardized Payment Amount | 243836.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 37 |
| Number Of Drug Services | 35557 |
| Number Of Medicare Beneficiaries With Drug Services | 64 |
| Total Drug Submitted ChargeAmount | 491839.89 |
| Total Drug Medicare AllowedAmount | 215749.76 |
| Total Drug Medicare PaymentAmount | 168541.94 |
| Total Drug Medicare Standardized Payment Amount | 168541.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 2267 |
| Number Of Medicare Beneficiaries With Medical Services | 278 |
| Total Medical Submitted Charge Amount | 281504.15 |
| Total Medical Medicare Allowed Amount | 96732.82 |
| Total Medical Medicare Payment Amount | 72461.58 |
| Total Medical Medicare Standardized Payment Amount | 75294.66 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 99 |
| Number Of Beneficiaries Age 75 to 84 | 90 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 168 |
| Number Of Male Beneficiaries | 112 |
| Number Of Non Hispanic White Beneficiaries | 263 |
| Number Of Black or African American Beneficiaries | |
| 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 | 195 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 85 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 31 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.9201 |