| National Provider Identifier [NPI]: | 1811083116 |
| Last Name Of The Provider | FERNANDES |
| First Name Of The Provider | LAURA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 920 MEDICAL PLAZA DR |
| Street Address 2 Of The Provider | SUITE 520 |
| City Of The Provider | SHENANDOAH |
| Zip Code Of The Provider | 773803260 |
| 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 | 72 |
| Number Of Services | 3972 |
| Number Of Medicare Beneficiaries | 1527 |
| Total Submitted Charge Amount | 931672.08 |
| Total Medicare Allowed Amount | 258549.97 |
| Total Medicare Payment Amount | 196045.88 |
| Total Medicare Standardized Payment Amount | 207106.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 57 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 8708 |
| Total Drug Medicare AllowedAmount | 3006.99 |
| Total Drug Medicare PaymentAmount | 2234.22 |
| Total Drug Medicare Standardized Payment Amount | 2234.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 71 |
| Number Of Medical Services | 3915 |
| Number Of Medicare Beneficiaries With Medical Services | 1527 |
| Total Medical Submitted Charge Amount | 922964.08 |
| Total Medical Medicare Allowed Amount | 255542.98 |
| Total Medical Medicare Payment Amount | 193811.66 |
| Total Medical Medicare Standardized Payment Amount | 204872.01 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 234 |
| Number Of Beneficiaries Age 65 to 74 | 570 |
| Number Of Beneficiaries Age 75 to 84 | 487 |
| Number Of Beneficiaries Age Greater 84 | 236 |
| Number Of Female Beneficiaries | 840 |
| Number Of Male Beneficiaries | 687 |
| Number Of Non Hispanic White Beneficiaries | 1316 |
| Number Of Black or African American Beneficiaries | 108 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 83 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1195 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 332 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.9314 |