| National Provider Identifier [NPI]: | 1033395629 |
| Last Name Of The Provider | MOSQUERA |
| First Name Of The Provider | GUSTAVO |
| 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 | 101 E PLUMMER BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHATHAM |
| Zip Code Of The Provider | 626298047 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 1807 |
| Number Of Medicare Beneficiaries | 328 |
| Total Submitted Charge Amount | 226965 |
| Total Medicare Allowed Amount | 90190 |
| Total Medicare Payment Amount | 60429.34 |
| Total Medicare Standardized Payment Amount | 63692.72 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 145 |
| Number Of Medicare Beneficiaries With Drug Services | 107 |
| Total Drug Submitted ChargeAmount | 12121 |
| Total Drug Medicare AllowedAmount | 4697.44 |
| Total Drug Medicare PaymentAmount | 4502.08 |
| Total Drug Medicare Standardized Payment Amount | 4502.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 1662 |
| Number Of Medicare Beneficiaries With Medical Services | 328 |
| Total Medical Submitted Charge Amount | 214844 |
| Total Medical Medicare Allowed Amount | 85492.56 |
| Total Medical Medicare Payment Amount | 55927.26 |
| Total Medical Medicare Standardized Payment Amount | 59190.64 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 128 |
| Number Of Beneficiaries Age 75 to 84 | 100 |
| Number Of Beneficiaries Age Greater 84 | 53 |
| Number Of Female Beneficiaries | 187 |
| Number Of Male Beneficiaries | 141 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 294 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1661 |