| National Provider Identifier [NPI]: | 1518909167 |
| Last Name Of The Provider | VAZQUEZ |
| First Name Of The Provider | ALEXIS |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1361 13TH AVE S |
| Street Address 2 Of The Provider | SUITE 245 |
| City Of The Provider | JACKSONVILLE BEACH |
| Zip Code Of The Provider | 322503233 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 10672.1 |
| Number Of Medicare Beneficiaries | 1093 |
| Total Submitted Charge Amount | 1414751.65 |
| Total Medicare Allowed Amount | 696762.69 |
| Total Medicare Payment Amount | 544383.64 |
| Total Medicare Standardized Payment Amount | 553578.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 164.1 |
| Number Of Medicare Beneficiaries With Drug Services | 68 |
| Total Drug Submitted ChargeAmount | 3546.65 |
| Total Drug Medicare AllowedAmount | 1773.08 |
| Total Drug Medicare PaymentAmount | 1683.3 |
| Total Drug Medicare Standardized Payment Amount | 1683.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 10508 |
| Number Of Medicare Beneficiaries With Medical Services | 1093 |
| Total Medical Submitted Charge Amount | 1411205 |
| Total Medical Medicare Allowed Amount | 694989.61 |
| Total Medical Medicare Payment Amount | 542700.34 |
| Total Medical Medicare Standardized Payment Amount | 551895.08 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 184 |
| Number Of Beneficiaries Age 65 to 74 | 352 |
| Number Of Beneficiaries Age 75 to 84 | 317 |
| Number Of Beneficiaries Age Greater 84 | 240 |
| Number Of Female Beneficiaries | 628 |
| Number Of Male Beneficiaries | 465 |
| Number Of Non Hispanic White Beneficiaries | 897 |
| Number Of Black or African American Beneficiaries | 126 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | 46 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 751 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 342 |
| Percent Of With Atrial Fibrillation | 32 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 24 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 61 |
| Percent Of With Chronic Kidney Disease | 57 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 75 |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 73 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.7792 |