| National Provider Identifier [NPI]: | 1841370285 |
| Last Name Of The Provider | DIEZ |
| First Name Of The Provider | JOSE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6624 FANNIN ST |
| Street Address 2 Of The Provider | STE 2220 |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770302312 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 1864 |
| Number Of Medicare Beneficiaries | 370 |
| Total Submitted Charge Amount | 681555.12 |
| Total Medicare Allowed Amount | 220632.06 |
| Total Medicare Payment Amount | 168508.42 |
| Total Medicare Standardized Payment Amount | 158706.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 104 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 17837.12 |
| Total Drug Medicare AllowedAmount | 2512.67 |
| Total Drug Medicare PaymentAmount | 1847.97 |
| Total Drug Medicare Standardized Payment Amount | 1847.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 1760 |
| Number Of Medicare Beneficiaries With Medical Services | 370 |
| Total Medical Submitted Charge Amount | 663718 |
| Total Medical Medicare Allowed Amount | 218119.39 |
| Total Medical Medicare Payment Amount | 166660.45 |
| Total Medical Medicare Standardized Payment Amount | 156858.27 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 55 |
| Number Of Beneficiaries Age 65 to 74 | 156 |
| Number Of Beneficiaries Age 75 to 84 | 99 |
| Number Of Beneficiaries Age Greater 84 | 60 |
| Number Of Female Beneficiaries | 169 |
| Number Of Male Beneficiaries | 201 |
| Number Of Non Hispanic White Beneficiaries | 223 |
| Number Of Black or African American Beneficiaries | 81 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 49 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 296 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 74 |
| Percent Of With Atrial Fibrillation | 36 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 67 |
| Percent Of With Chronic Kidney Disease | 56 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.6033 |