| National Provider Identifier [NPI]: | 1619907284 |
| Last Name Of The Provider | VINES |
| First Name Of The Provider | STEVEN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 451 W GONZALES RD |
| Street Address 2 Of The Provider | STE 260 |
| City Of The Provider | OXNARD |
| Zip Code Of The Provider | 930369004 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 1294 |
| Number Of Medicare Beneficiaries | 485 |
| Total Submitted Charge Amount | 144868.16 |
| Total Medicare Allowed Amount | 112092.09 |
| Total Medicare Payment Amount | 83441.92 |
| Total Medicare Standardized Payment Amount | 76334.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 1294 |
| Number Of Medicare Beneficiaries With Medical Services | 485 |
| Total Medical Submitted Charge Amount | 144868.16 |
| Total Medical Medicare Allowed Amount | 112092.09 |
| Total Medical Medicare Payment Amount | 83441.92 |
| Total Medical Medicare Standardized Payment Amount | 76334.61 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 64 |
| Number Of Beneficiaries Age 65 to 74 | 153 |
| Number Of Beneficiaries Age 75 to 84 | 157 |
| Number Of Beneficiaries Age Greater 84 | 111 |
| Number Of Female Beneficiaries | 300 |
| Number Of Male Beneficiaries | 185 |
| Number Of Non Hispanic White Beneficiaries | 314 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 131 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 338 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 147 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.7436 |