| National Provider Identifier [NPI]: | 1750464699 |
| Last Name Of The Provider | CESANI-VAZQUEZ |
| First Name Of The Provider | FERNANDO |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 301 UNIVERSITY BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | GALVESTON |
| Zip Code Of The Provider | 775555302 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nuclear Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 109 |
| Number Of Services | 4099 |
| Number Of Medicare Beneficiaries | 2701 |
| Total Submitted Charge Amount | 249582 |
| Total Medicare Allowed Amount | 102473.38 |
| Total Medicare Payment Amount | 77251.96 |
| Total Medicare Standardized Payment Amount | 77045.6 |
| 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 | 109 |
| Number Of Medical Services | 4099 |
| Number Of Medicare Beneficiaries With Medical Services | 2701 |
| Total Medical Submitted Charge Amount | 249582 |
| Total Medical Medicare Allowed Amount | 102473.38 |
| Total Medical Medicare Payment Amount | 77251.96 |
| Total Medical Medicare Standardized Payment Amount | 77045.6 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 615 |
| Number Of Beneficiaries Age 65 to 74 | 1080 |
| Number Of Beneficiaries Age 75 to 84 | 683 |
| Number Of Beneficiaries Age Greater 84 | 323 |
| Number Of Female Beneficiaries | 1674 |
| Number Of Male Beneficiaries | 1027 |
| Number Of Non Hispanic White Beneficiaries | 1655 |
| Number Of Black or African American Beneficiaries | 595 |
| Number Of AsianPacific Islander Beneficiaries | 33 |
| Number Of Hispanic Beneficiaries | 395 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1982 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 719 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.8436 |