| National Provider Identifier [NPI]: | 1164448098 |
| Last Name Of The Provider | HERNANDEZ |
| First Name Of The Provider | ERNESTO |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 687 MARIETTA HWY |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | CANTON |
| Zip Code Of The Provider | 301142608 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 3891 |
| Number Of Medicare Beneficiaries | 1819 |
| Total Submitted Charge Amount | 401962 |
| Total Medicare Allowed Amount | 187888.29 |
| Total Medicare Payment Amount | 137899.08 |
| Total Medicare Standardized Payment Amount | 139275.71 |
| 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 | 51 |
| Number Of Medical Services | 3891 |
| Number Of Medicare Beneficiaries With Medical Services | 1819 |
| Total Medical Submitted Charge Amount | 401962 |
| Total Medical Medicare Allowed Amount | 187888.29 |
| Total Medical Medicare Payment Amount | 137899.08 |
| Total Medical Medicare Standardized Payment Amount | 139275.71 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 242 |
| Number Of Beneficiaries Age 65 to 74 | 606 |
| Number Of Beneficiaries Age 75 to 84 | 620 |
| Number Of Beneficiaries Age Greater 84 | 351 |
| Number Of Female Beneficiaries | 972 |
| Number Of Male Beneficiaries | 847 |
| Number Of Non Hispanic White Beneficiaries | 1531 |
| Number Of Black or African American Beneficiaries | 197 |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| Number Of Hispanic Beneficiaries | 59 |
| 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 | 1476 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 343 |
| Percent Of With Atrial Fibrillation | 37 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 1.9835 |