| National Provider Identifier [NPI]: | 1134190135 |
| Last Name Of The Provider | CRUZ |
| First Name Of The Provider | ERNESTO |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2632 N 20TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PHOENIX |
| Zip Code Of The Provider | 850061339 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 68 |
| Number Of Services | 11823 |
| Number Of Medicare Beneficiaries | 1768 |
| Total Submitted Charge Amount | 2509462 |
| Total Medicare Allowed Amount | 837469.33 |
| Total Medicare Payment Amount | 627156.14 |
| Total Medicare Standardized Payment Amount | 653292.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 6871 |
| Number Of Medicare Beneficiaries With Drug Services | 268 |
| Total Drug Submitted ChargeAmount | 144630 |
| Total Drug Medicare AllowedAmount | 45978.16 |
| Total Drug Medicare PaymentAmount | 35269.06 |
| Total Drug Medicare Standardized Payment Amount | 35269.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 64 |
| Number Of Medical Services | 4952 |
| Number Of Medicare Beneficiaries With Medical Services | 1767 |
| Total Medical Submitted Charge Amount | 2364832 |
| Total Medical Medicare Allowed Amount | 791491.17 |
| Total Medical Medicare Payment Amount | 591887.08 |
| Total Medical Medicare Standardized Payment Amount | 618023.89 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 111 |
| Number Of Beneficiaries Age 65 to 74 | 750 |
| Number Of Beneficiaries Age 75 to 84 | 713 |
| Number Of Beneficiaries Age Greater 84 | 194 |
| Number Of Female Beneficiaries | 689 |
| Number Of Male Beneficiaries | 1079 |
| Number Of Non Hispanic White Beneficiaries | 1494 |
| Number Of Black or African American Beneficiaries | 51 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 96 |
| Number Of American Indian Alaska Native Beneficiaries | 81 |
| Number Of Beneficiaries With Race Not Else where Classified | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1613 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 155 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 74 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4619 |