| National Provider Identifier [NPI]: | 1043279037 |
| Last Name Of The Provider | NEPOMUCENO |
| First Name Of The Provider | ARLENE |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 420 W ROWLAND ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | COVINA |
| Zip Code Of The Provider | 917232943 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 301 |
| Number Of Medicare Beneficiaries | 82 |
| Total Submitted Charge Amount | 27743 |
| Total Medicare Allowed Amount | 19523.33 |
| Total Medicare Payment Amount | 13627.7 |
| Total Medicare Standardized Payment Amount | 12339.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 32 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 588 |
| Total Drug Medicare AllowedAmount | 172.8 |
| Total Drug Medicare PaymentAmount | 164.51 |
| Total Drug Medicare Standardized Payment Amount | 164.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 269 |
| Number Of Medicare Beneficiaries With Medical Services | 82 |
| Total Medical Submitted Charge Amount | 27155 |
| Total Medical Medicare Allowed Amount | 19350.53 |
| Total Medical Medicare Payment Amount | 13463.19 |
| Total Medical Medicare Standardized Payment Amount | 12175.39 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 29 |
| Number Of Beneficiaries Age 75 to 84 | 25 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 70 |
| Number Of Male Beneficiaries | 12 |
| Number Of Non Hispanic White Beneficiaries | 35 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 36 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 53 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 29 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 21 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1344 |