| National Provider Identifier [NPI]: | 1184708034 |
| Last Name Of The Provider | FERNANDEZ |
| First Name Of The Provider | MIGUEL |
| 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 | 770 PINE ST STE 290 |
| Street Address 2 Of The Provider | ATTN: RADIOLOGY DEPARTMENT |
| City Of The Provider | MACON |
| Zip Code Of The Provider | 312017516 |
| 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 | 212 |
| Number Of Services | 10477 |
| Number Of Medicare Beneficiaries | 4364 |
| Total Submitted Charge Amount | 1292789 |
| Total Medicare Allowed Amount | 305648.33 |
| Total Medicare Payment Amount | 231507.54 |
| Total Medicare Standardized Payment Amount | 246482.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 3308 |
| Number Of Medicare Beneficiaries With Drug Services | 124 |
| Total Drug Submitted ChargeAmount | 20578 |
| Total Drug Medicare AllowedAmount | 2690.53 |
| Total Drug Medicare PaymentAmount | 2109.46 |
| Total Drug Medicare Standardized Payment Amount | 2109.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 208 |
| Number Of Medical Services | 7169 |
| Number Of Medicare Beneficiaries With Medical Services | 4363 |
| Total Medical Submitted Charge Amount | 1272211 |
| Total Medical Medicare Allowed Amount | 302957.8 |
| Total Medical Medicare Payment Amount | 229398.08 |
| Total Medical Medicare Standardized Payment Amount | 244373.23 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 1039 |
| Number Of Beneficiaries Age 65 to 74 | 1488 |
| Number Of Beneficiaries Age 75 to 84 | 1212 |
| Number Of Beneficiaries Age Greater 84 | 625 |
| Number Of Female Beneficiaries | 2374 |
| Number Of Male Beneficiaries | 1990 |
| Number Of Non Hispanic White Beneficiaries | 2903 |
| Number Of Black or African American Beneficiaries | 1399 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3014 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1350 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.1205 |