| National Provider Identifier [NPI]: | 1245263284 |
| Last Name Of The Provider | FUENTES |
| First Name Of The Provider | FRANCISCO |
| 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 | 6410 FANNIN ST |
| Street Address 2 Of The Provider | 600 |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770303000 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 2845 |
| Number Of Medicare Beneficiaries | 1605 |
| Total Submitted Charge Amount | 661829 |
| Total Medicare Allowed Amount | 178904.21 |
| Total Medicare Payment Amount | 129552.91 |
| Total Medicare Standardized Payment Amount | 129616.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 63 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 3210 |
| Total Drug Medicare AllowedAmount | 996.39 |
| Total Drug Medicare PaymentAmount | 809.49 |
| Total Drug Medicare Standardized Payment Amount | 809.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 2782 |
| Number Of Medicare Beneficiaries With Medical Services | 1605 |
| Total Medical Submitted Charge Amount | 658619 |
| Total Medical Medicare Allowed Amount | 177907.82 |
| Total Medical Medicare Payment Amount | 128743.42 |
| Total Medical Medicare Standardized Payment Amount | 128806.88 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 330 |
| Number Of Beneficiaries Age 65 to 74 | 598 |
| Number Of Beneficiaries Age 75 to 84 | 458 |
| Number Of Beneficiaries Age Greater 84 | 219 |
| Number Of Female Beneficiaries | 808 |
| Number Of Male Beneficiaries | 797 |
| Number Of Non Hispanic White Beneficiaries | 909 |
| Number Of Black or African American Beneficiaries | 393 |
| Number Of AsianPacific Islander Beneficiaries | 39 |
| Number Of Hispanic Beneficiaries | 244 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1180 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 425 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 54 |
| Percent Of With Chronic Kidney Disease | 54 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 72 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 21 |
| Average HCC Risk Score Of Beneficiaries | 2.3161 |