| National Provider Identifier [NPI]: | 1447529904 |
| Last Name Of The Provider | DURU |
| First Name Of The Provider | VIVIAN |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2009 TIDEWATER COLONY DR |
| Street Address 2 Of The Provider | #2A |
| City Of The Provider | ANNAPOLIS |
| Zip Code Of The Provider | 214012107 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 14 |
| Number Of Services | 243 |
| Number Of Medicare Beneficiaries | 159 |
| Total Submitted Charge Amount | 30383 |
| Total Medicare Allowed Amount | 18455.34 |
| Total Medicare Payment Amount | 13497.31 |
| Total Medicare Standardized Payment Amount | 15052.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 13 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 652 |
| Total Drug Medicare AllowedAmount | 250.08 |
| Total Drug Medicare PaymentAmount | 245.09 |
| Total Drug Medicare Standardized Payment Amount | 245.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 12 |
| Number Of Medical Services | 230 |
| Number Of Medicare Beneficiaries With Medical Services | 159 |
| Total Medical Submitted Charge Amount | 29731 |
| Total Medical Medicare Allowed Amount | 18205.26 |
| Total Medical Medicare Payment Amount | 13252.22 |
| Total Medical Medicare Standardized Payment Amount | 14806.97 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 83 |
| Number Of Beneficiaries Age 75 to 84 | 47 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 99 |
| Number Of Male Beneficiaries | 60 |
| Number Of Non Hispanic White Beneficiaries | 125 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 8 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.902 |