| National Provider Identifier [NPI]: | 1063407526 |
| Last Name Of The Provider | VANEXAN |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3226 S ALAMEDA ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CORPUS CHRISTI |
| Zip Code Of The Provider | 784042508 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 193 |
| Number Of Services | 12505 |
| Number Of Medicare Beneficiaries | 3453 |
| Total Submitted Charge Amount | 1414110.5 |
| Total Medicare Allowed Amount | 321391.99 |
| Total Medicare Payment Amount | 240767.73 |
| Total Medicare Standardized Payment Amount | 261638.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 6987 |
| Number Of Medicare Beneficiaries With Drug Services | 204 |
| Total Drug Submitted ChargeAmount | 10953.5 |
| Total Drug Medicare AllowedAmount | 5434.44 |
| Total Drug Medicare PaymentAmount | 4193.67 |
| Total Drug Medicare Standardized Payment Amount | 4193.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 189 |
| Number Of Medical Services | 5518 |
| Number Of Medicare Beneficiaries With Medical Services | 3452 |
| Total Medical Submitted Charge Amount | 1403157 |
| Total Medical Medicare Allowed Amount | 315957.55 |
| Total Medical Medicare Payment Amount | 236574.06 |
| Total Medical Medicare Standardized Payment Amount | 257445.21 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 775 |
| Number Of Beneficiaries Age 65 to 74 | 1181 |
| Number Of Beneficiaries Age 75 to 84 | 980 |
| Number Of Beneficiaries Age Greater 84 | 517 |
| Number Of Female Beneficiaries | 1967 |
| Number Of Male Beneficiaries | 1486 |
| Number Of Non Hispanic White Beneficiaries | 1609 |
| Number Of Black or African American Beneficiaries | 117 |
| Number Of AsianPacific Islander Beneficiaries | 27 |
| Number Of Hispanic Beneficiaries | 1679 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2094 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1359 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.1028 |