| National Provider Identifier [NPI]: | 1841433687 |
| Last Name Of The Provider | LOPEZ |
| First Name Of The Provider | LUIS |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1627 CHEW ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | ALLENTOWN |
| Zip Code Of The Provider | 181023648 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 521 |
| Number Of Medicare Beneficiaries | 136 |
| Total Submitted Charge Amount | 70695 |
| Total Medicare Allowed Amount | 36584.96 |
| Total Medicare Payment Amount | 24983.26 |
| Total Medicare Standardized Payment Amount | 26139.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 71 |
| Number Of Medicare Beneficiaries With Drug Services | 55 |
| Total Drug Submitted ChargeAmount | 3490 |
| Total Drug Medicare AllowedAmount | 2379.32 |
| Total Drug Medicare PaymentAmount | 2329.73 |
| Total Drug Medicare Standardized Payment Amount | 2329.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 450 |
| Number Of Medicare Beneficiaries With Medical Services | 136 |
| Total Medical Submitted Charge Amount | 67205 |
| Total Medical Medicare Allowed Amount | 34205.64 |
| Total Medical Medicare Payment Amount | 22653.53 |
| Total Medical Medicare Standardized Payment Amount | 23810.18 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 49 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 80 |
| Number Of Male Beneficiaries | 56 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 125 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 28 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 108 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 21 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 1.1117 |