| National Provider Identifier [NPI]: | 1538139936 |
| Last Name Of The Provider | LOPEZ |
| First Name Of The Provider | MARIA |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10111 W FOREST HILL BLVD |
| Street Address 2 Of The Provider | SUITE 255 |
| City Of The Provider | WELLINGTON |
| Zip Code Of The Provider | 334146108 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 828 |
| Number Of Medicare Beneficiaries | 205 |
| Total Submitted Charge Amount | 147818 |
| Total Medicare Allowed Amount | 81614.88 |
| Total Medicare Payment Amount | 59023.42 |
| Total Medicare Standardized Payment Amount | 56518.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 48 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 1975 |
| Total Drug Medicare AllowedAmount | 234.95 |
| Total Drug Medicare PaymentAmount | 211.09 |
| Total Drug Medicare Standardized Payment Amount | 211.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 780 |
| Number Of Medicare Beneficiaries With Medical Services | 205 |
| Total Medical Submitted Charge Amount | 145843 |
| Total Medical Medicare Allowed Amount | 81379.93 |
| Total Medical Medicare Payment Amount | 58812.33 |
| Total Medical Medicare Standardized Payment Amount | 56307.57 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 85 |
| Number Of Beneficiaries Age 75 to 84 | 69 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 144 |
| Number Of Male Beneficiaries | 61 |
| Number Of Non Hispanic White Beneficiaries | 112 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 70 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 154 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 51 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.1176 |