| National Provider Identifier [NPI]: | 1619943941 |
| Last Name Of The Provider | VEGA |
| First Name Of The Provider | MANUEL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD, FACC, FSCAI |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 206A HOSPITAL DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | DUBLIN |
| Zip Code Of The Provider | 310212989 |
| 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 | 112 |
| Number Of Services | 10721 |
| Number Of Medicare Beneficiaries | 1785 |
| Total Submitted Charge Amount | 4068729 |
| Total Medicare Allowed Amount | 1037423.03 |
| Total Medicare Payment Amount | 778699.27 |
| Total Medicare Standardized Payment Amount | 830002.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 1062 |
| Number Of Medicare Beneficiaries With Drug Services | 277 |
| Total Drug Submitted ChargeAmount | 103535 |
| Total Drug Medicare AllowedAmount | 53755.22 |
| Total Drug Medicare PaymentAmount | 41666.27 |
| Total Drug Medicare Standardized Payment Amount | 41666.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 103 |
| Number Of Medical Services | 9659 |
| Number Of Medicare Beneficiaries With Medical Services | 1785 |
| Total Medical Submitted Charge Amount | 3965194 |
| Total Medical Medicare Allowed Amount | 983667.81 |
| Total Medical Medicare Payment Amount | 737033 |
| Total Medical Medicare Standardized Payment Amount | 788336.46 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 420 |
| Number Of Beneficiaries Age 65 to 74 | 580 |
| Number Of Beneficiaries Age 75 to 84 | 548 |
| Number Of Beneficiaries Age Greater 84 | 237 |
| Number Of Female Beneficiaries | 1027 |
| Number Of Male Beneficiaries | 758 |
| Number Of Non Hispanic White Beneficiaries | 1250 |
| Number Of Black or African American Beneficiaries | 508 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1071 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 714 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.9719 |