| National Provider Identifier [NPI]: | 1326159385 |
| Last Name Of The Provider | LOPEZ |
| First Name Of The Provider | ROSSANA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 777 E 25TH ST |
| Street Address 2 Of The Provider | SUITE 516 |
| City Of The Provider | HIALEAH |
| Zip Code Of The Provider | 330133825 |
| 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 | 27 |
| Number Of Services | 4829 |
| Number Of Medicare Beneficiaries | 886 |
| Total Submitted Charge Amount | 1072220 |
| Total Medicare Allowed Amount | 408925.88 |
| Total Medicare Payment Amount | 318761.59 |
| Total Medicare Standardized Payment Amount | 294472.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 40 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 220 |
| Total Drug Medicare AllowedAmount | 13.83 |
| Total Drug Medicare PaymentAmount | 10.81 |
| Total Drug Medicare Standardized Payment Amount | 10.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 4789 |
| Number Of Medicare Beneficiaries With Medical Services | 886 |
| Total Medical Submitted Charge Amount | 1072000 |
| Total Medical Medicare Allowed Amount | 408912.05 |
| Total Medical Medicare Payment Amount | 318750.78 |
| Total Medical Medicare Standardized Payment Amount | 294462.17 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 138 |
| Number Of Beneficiaries Age 65 to 74 | 279 |
| Number Of Beneficiaries Age 75 to 84 | 268 |
| Number Of Beneficiaries Age Greater 84 | 201 |
| Number Of Female Beneficiaries | 544 |
| Number Of Male Beneficiaries | 342 |
| Number Of Non Hispanic White Beneficiaries | 63 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 787 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 67 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 819 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 55 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 49 |
| Percent Of With Depression | 69 |
| Percent Of With Diabetes | 73 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 74 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 28 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.3603 |