| National Provider Identifier [NPI]: | 1316966252 |
| Last Name Of The Provider | LOPEZ-ACEVEDO |
| First Name Of The Provider | MARJERY |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | AVE. SEVERIANO CUEVAS #18 |
| Street Address 2 Of The Provider | |
| City Of The Provider | AGUADILLA |
| Zip Code Of The Provider | 006054055 |
| State Code Of The Provider | PR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 5704 |
| Number Of Medicare Beneficiaries | 1161 |
| Total Submitted Charge Amount | 1015110 |
| Total Medicare Allowed Amount | 498480.26 |
| Total Medicare Payment Amount | 378130.84 |
| Total Medicare Standardized Payment Amount | 377712.48 |
| 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 | 36 |
| Number Of Medical Services | 5704 |
| Number Of Medicare Beneficiaries With Medical Services | 1161 |
| Total Medical Submitted Charge Amount | 1015110 |
| Total Medical Medicare Allowed Amount | 498480.26 |
| Total Medical Medicare Payment Amount | 378130.84 |
| Total Medical Medicare Standardized Payment Amount | 377712.48 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 108 |
| Number Of Beneficiaries Age 65 to 74 | 441 |
| Number Of Beneficiaries Age 75 to 84 | 445 |
| Number Of Beneficiaries Age Greater 84 | 167 |
| Number Of Female Beneficiaries | 574 |
| Number Of Male Beneficiaries | 587 |
| Number Of Non Hispanic White Beneficiaries | 1075 |
| Number Of Black or African American Beneficiaries | 32 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 42 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 970 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 191 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 68 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 72 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.3655 |