| National Provider Identifier [NPI]: | 1265481618 |
| Last Name Of The Provider | MATTOS |
| First Name Of The Provider | GAMALIEL |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4001 NW 97TH AVE |
| Street Address 2 Of The Provider | SUITE101 |
| City Of The Provider | DORAL |
| Zip Code Of The Provider | 331782384 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 5547 |
| Number Of Medicare Beneficiaries | 517 |
| Total Submitted Charge Amount | 778775 |
| Total Medicare Allowed Amount | 551503.04 |
| Total Medicare Payment Amount | 440545.26 |
| Total Medicare Standardized Payment Amount | 412951.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 281 |
| Number Of Medicare Beneficiaries With Drug Services | 265 |
| Total Drug Submitted ChargeAmount | 5680 |
| Total Drug Medicare AllowedAmount | 4119.52 |
| Total Drug Medicare PaymentAmount | 4032.42 |
| Total Drug Medicare Standardized Payment Amount | 4032.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 5266 |
| Number Of Medicare Beneficiaries With Medical Services | 517 |
| Total Medical Submitted Charge Amount | 773095 |
| Total Medical Medicare Allowed Amount | 547383.52 |
| Total Medical Medicare Payment Amount | 436512.84 |
| Total Medical Medicare Standardized Payment Amount | 408919.15 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 126 |
| Number Of Beneficiaries Age 65 to 74 | 80 |
| Number Of Beneficiaries Age 75 to 84 | 146 |
| Number Of Beneficiaries Age Greater 84 | 165 |
| Number Of Female Beneficiaries | 330 |
| Number Of Male Beneficiaries | 187 |
| Number Of Non Hispanic White Beneficiaries | 75 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 402 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 45 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 472 |
| Percent Of With Atrial Fibrillation | 3 |
| Percent Of With Alzheimers Disease or Dementia | 60 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 56 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 22 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 68 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 39 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 2.0251 |