| National Provider Identifier [NPI]: | 1851334874 |
| Last Name Of The Provider | GOMEZ |
| First Name Of The Provider | ANGEL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D., M.P.H. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | ADMINISTRACION SERVICIOS MEDICOS DE P.R. |
| Street Address 2 Of The Provider | UPR-RCM RADIOLOGIA, CARR. 22, BO. MONACILLOS |
| City Of The Provider | SAN JUAN |
| Zip Code Of The Provider | 009352129 |
| State Code Of The Provider | PR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 155 |
| Number Of Services | 3602 |
| Number Of Medicare Beneficiaries | 1515 |
| Total Submitted Charge Amount | 293008.06 |
| Total Medicare Allowed Amount | 66896.66 |
| Total Medicare Payment Amount | 49437.19 |
| Total Medicare Standardized Payment Amount | 56943.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1156 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 412.72 |
| Total Drug Medicare AllowedAmount | 262.88 |
| Total Drug Medicare PaymentAmount | 178.94 |
| Total Drug Medicare Standardized Payment Amount | 178.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 153 |
| Number Of Medical Services | 2446 |
| Number Of Medicare Beneficiaries With Medical Services | 1515 |
| Total Medical Submitted Charge Amount | 292595.34 |
| Total Medical Medicare Allowed Amount | 66633.78 |
| Total Medical Medicare Payment Amount | 49258.25 |
| Total Medical Medicare Standardized Payment Amount | 56764.7 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 487 |
| Number Of Beneficiaries Age 65 to 74 | 585 |
| Number Of Beneficiaries Age 75 to 84 | 322 |
| Number Of Beneficiaries Age Greater 84 | 121 |
| Number Of Female Beneficiaries | 932 |
| Number Of Male Beneficiaries | 583 |
| Number Of Non Hispanic White Beneficiaries | 933 |
| Number Of Black or African American Beneficiaries | 409 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 160 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1156 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 359 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 64 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.8169 |