| National Provider Identifier [NPI]: | 1730189671 |
| Last Name Of The Provider | CRUZ |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | A8 AVE 65 INFANTERIA |
| Street Address 2 Of The Provider | URB SAN AGUSTIN |
| City Of The Provider | SAN JUAN |
| Zip Code Of The Provider | 009290460 |
| State Code Of The Provider | PR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 186 |
| Number Of Services | 21320 |
| Number Of Medicare Beneficiaries | 4640 |
| Total Submitted Charge Amount | 453011.05 |
| Total Medicare Allowed Amount | 445354.41 |
| Total Medicare Payment Amount | 343072.47 |
| Total Medicare Standardized Payment Amount | 420513.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 5618 |
| Number Of Medicare Beneficiaries With Drug Services | 78 |
| Total Drug Submitted ChargeAmount | 3960.8 |
| Total Drug Medicare AllowedAmount | 1527.66 |
| Total Drug Medicare PaymentAmount | 1173.32 |
| Total Drug Medicare Standardized Payment Amount | 1173.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 184 |
| Number Of Medical Services | 15702 |
| Number Of Medicare Beneficiaries With Medical Services | 4637 |
| Total Medical Submitted Charge Amount | 449050.25 |
| Total Medical Medicare Allowed Amount | 443826.75 |
| Total Medical Medicare Payment Amount | 341899.15 |
| Total Medical Medicare Standardized Payment Amount | 419340.41 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 881 |
| Number Of Beneficiaries Age 65 to 74 | 1431 |
| Number Of Beneficiaries Age 75 to 84 | 1544 |
| Number Of Beneficiaries Age Greater 84 | 784 |
| Number Of Female Beneficiaries | 2787 |
| Number Of Male Beneficiaries | 1853 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 4585 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 4566 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 74 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 67 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.2004 |