| National Provider Identifier [NPI]: | 1467491647 |
| Last Name Of The Provider | CESPEDES |
| First Name Of The Provider | LUZ |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 33 WALT WHITMAN RD |
| Street Address 2 Of The Provider | SUITE 240 |
| City Of The Provider | HUNTINGTON STATION |
| Zip Code Of The Provider | 117463640 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 364 |
| Number Of Medicare Beneficiaries | 50 |
| Total Submitted Charge Amount | 43658.06 |
| Total Medicare Allowed Amount | 22925.29 |
| Total Medicare Payment Amount | 17723.48 |
| Total Medicare Standardized Payment Amount | 16214.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 25 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 1175 |
| Total Drug Medicare AllowedAmount | 334.69 |
| Total Drug Medicare PaymentAmount | 318.03 |
| Total Drug Medicare Standardized Payment Amount | 318.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 339 |
| Number Of Medicare Beneficiaries With Medical Services | 50 |
| Total Medical Submitted Charge Amount | 42483.06 |
| Total Medical Medicare Allowed Amount | 22590.6 |
| Total Medical Medicare Payment Amount | 17405.45 |
| Total Medical Medicare Standardized Payment Amount | 15896.34 |
| Average Age Of Beneficiaries | 60 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 30 |
| Number Of Male Beneficiaries | 20 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 0 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 24 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4267 |