| National Provider Identifier [NPI]: | 1073639829 |
| Last Name Of The Provider | GONZALEZ |
| First Name Of The Provider | DARIO |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | LIJMC - DEPT OF EMERGENCY MEDICINE |
| Street Address 2 Of The Provider | 270-05 76TH AVENUE |
| City Of The Provider | NEW HYDE PARK |
| Zip Code Of The Provider | 11040 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 13 |
| Number Of Services | 292 |
| Number Of Medicare Beneficiaries | 275 |
| Total Submitted Charge Amount | 291515 |
| Total Medicare Allowed Amount | 46191.08 |
| Total Medicare Payment Amount | 35790.66 |
| Total Medicare Standardized Payment Amount | 32006.78 |
| 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 | 13 |
| Number Of Medical Services | 292 |
| Number Of Medicare Beneficiaries With Medical Services | 275 |
| Total Medical Submitted Charge Amount | 291515 |
| Total Medical Medicare Allowed Amount | 46191.08 |
| Total Medical Medicare Payment Amount | 35790.66 |
| Total Medical Medicare Standardized Payment Amount | 32006.78 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 62 |
| Number Of Beneficiaries Age 75 to 84 | 78 |
| Number Of Beneficiaries Age Greater 84 | 88 |
| Number Of Female Beneficiaries | 154 |
| Number Of Male Beneficiaries | 121 |
| Number Of Non Hispanic White Beneficiaries | 149 |
| Number Of Black or African American Beneficiaries | 72 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 145 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 130 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 34 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 55 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.5201 |