| National Provider Identifier [NPI]: | 1922117571 |
| Last Name Of The Provider | LOPEZ |
| First Name Of The Provider | LOUIS |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 604 W BERRY ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT WAYNE |
| Zip Code Of The Provider | 468022106 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 81 |
| Number Of Services | 7097 |
| Number Of Medicare Beneficiaries | 808 |
| Total Submitted Charge Amount | 1484315 |
| Total Medicare Allowed Amount | 794297.86 |
| Total Medicare Payment Amount | 602884.29 |
| Total Medicare Standardized Payment Amount | 658283.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 880 |
| Number Of Medicare Beneficiaries With Drug Services | 220 |
| Total Drug Submitted ChargeAmount | 88000 |
| Total Drug Medicare AllowedAmount | 46590.88 |
| Total Drug Medicare PaymentAmount | 35639.27 |
| Total Drug Medicare Standardized Payment Amount | 35639.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 80 |
| Number Of Medical Services | 6217 |
| Number Of Medicare Beneficiaries With Medical Services | 808 |
| Total Medical Submitted Charge Amount | 1396315 |
| Total Medical Medicare Allowed Amount | 747706.98 |
| Total Medical Medicare Payment Amount | 567245.02 |
| Total Medical Medicare Standardized Payment Amount | 622644.26 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 179 |
| Number Of Beneficiaries Age 65 to 74 | 297 |
| Number Of Beneficiaries Age 75 to 84 | 217 |
| Number Of Beneficiaries Age Greater 84 | 115 |
| Number Of Female Beneficiaries | 431 |
| Number Of Male Beneficiaries | 377 |
| Number Of Non Hispanic White Beneficiaries | 625 |
| Number Of Black or African American Beneficiaries | 151 |
| 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 | 545 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 263 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 2.0708 |