| National Provider Identifier [NPI]: | 1790765063 |
| Last Name Of The Provider | VAZQUEZ |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 601 S 8TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | GRIFFIN |
| Zip Code Of The Provider | 302244213 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 198 |
| Number Of Services | 5650 |
| Number Of Medicare Beneficiaries | 3079 |
| Total Submitted Charge Amount | 504204 |
| Total Medicare Allowed Amount | 213487.61 |
| Total Medicare Payment Amount | 162556.79 |
| Total Medicare Standardized Payment Amount | 168047.49 |
| 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 | 198 |
| Number Of Medical Services | 5650 |
| Number Of Medicare Beneficiaries With Medical Services | 3079 |
| Total Medical Submitted Charge Amount | 504204 |
| Total Medical Medicare Allowed Amount | 213487.61 |
| Total Medical Medicare Payment Amount | 162556.79 |
| Total Medical Medicare Standardized Payment Amount | 168047.49 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 728 |
| Number Of Beneficiaries Age 65 to 74 | 998 |
| Number Of Beneficiaries Age 75 to 84 | 823 |
| Number Of Beneficiaries Age Greater 84 | 530 |
| Number Of Female Beneficiaries | 1752 |
| Number Of Male Beneficiaries | 1327 |
| Number Of Non Hispanic White Beneficiaries | 2923 |
| Number Of Black or African American Beneficiaries | 34 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 74 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2165 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 914 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 71 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 65 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.739 |