| National Provider Identifier [NPI]: | 1275836249 |
| Last Name Of The Provider | GOMEZ |
| First Name Of The Provider | LUISANA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | PHYSICIAN ASSISTANT |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 941 S ATLANTIC BLVD |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | MONTEREY PARK |
| Zip Code Of The Provider | 917544722 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 84 |
| Number Of Services | 10573 |
| Number Of Medicare Beneficiaries | 407 |
| Total Submitted Charge Amount | 1615617.06 |
| Total Medicare Allowed Amount | 361281.67 |
| Total Medicare Payment Amount | 274315.16 |
| Total Medicare Standardized Payment Amount | 296453.58 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 5268 |
| Number Of Medicare Beneficiaries With Drug Services | 318 |
| Total Drug Submitted ChargeAmount | 197342.5 |
| Total Drug Medicare AllowedAmount | 41920.21 |
| Total Drug Medicare PaymentAmount | 32768.77 |
| Total Drug Medicare Standardized Payment Amount | 32768.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 75 |
| Number Of Medical Services | 5305 |
| Number Of Medicare Beneficiaries With Medical Services | 407 |
| Total Medical Submitted Charge Amount | 1418274.56 |
| Total Medical Medicare Allowed Amount | 319361.46 |
| Total Medical Medicare Payment Amount | 241546.39 |
| Total Medical Medicare Standardized Payment Amount | 263684.81 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 89 |
| Number Of Beneficiaries Age 65 to 74 | 181 |
| Number Of Beneficiaries Age 75 to 84 | 112 |
| Number Of Beneficiaries Age Greater 84 | 25 |
| Number Of Female Beneficiaries | 324 |
| Number Of Male Beneficiaries | 83 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 387 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 25 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 382 |
| Percent Of With Atrial Fibrillation | 3 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 72 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 42 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.3436 |