| National Provider Identifier [NPI]: | 1275676678 |
| Last Name Of The Provider | VAZQUEZ |
| First Name Of The Provider | JOSUE |
| 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 | 285 PALMAS INN WAY |
| Street Address 2 Of The Provider | APT. 5-304 PALMANOVA VILLAGE |
| City Of The Provider | HUMACAO |
| Zip Code Of The Provider | 007916701 |
| 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 | 91 |
| Number Of Services | 712 |
| Number Of Medicare Beneficiaries | 429 |
| Total Submitted Charge Amount | 15626.29 |
| Total Medicare Allowed Amount | 15566.62 |
| Total Medicare Payment Amount | 11098.69 |
| Total Medicare Standardized Payment Amount | 12367.76 |
| 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 | 91 |
| Number Of Medical Services | 712 |
| Number Of Medicare Beneficiaries With Medical Services | 429 |
| Total Medical Submitted Charge Amount | 15626.29 |
| Total Medical Medicare Allowed Amount | 15566.62 |
| Total Medical Medicare Payment Amount | 11098.69 |
| Total Medical Medicare Standardized Payment Amount | 12367.76 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 104 |
| Number Of Beneficiaries Age 65 to 74 | 133 |
| Number Of Beneficiaries Age 75 to 84 | 129 |
| Number Of Beneficiaries Age Greater 84 | 63 |
| Number Of Female Beneficiaries | 255 |
| Number Of Male Beneficiaries | 174 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 410 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 19 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 66 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.266 |