| National Provider Identifier [NPI]: | 1043393465 |
| Last Name Of The Provider | PEREZ |
| First Name Of The Provider | OMAR |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10728 E RAMONA BLVD |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | EL MONTE |
| Zip Code Of The Provider | 91731 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 859 |
| Number Of Medicare Beneficiaries | 201 |
| Total Submitted Charge Amount | 71676.03 |
| Total Medicare Allowed Amount | 63994.37 |
| Total Medicare Payment Amount | 52626.81 |
| Total Medicare Standardized Payment Amount | 49355.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 77 |
| Number Of Medicare Beneficiaries With Drug Services | 67 |
| Total Drug Submitted ChargeAmount | 4860 |
| Total Drug Medicare AllowedAmount | 2528.66 |
| Total Drug Medicare PaymentAmount | 2477.08 |
| Total Drug Medicare Standardized Payment Amount | 2477.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 782 |
| Number Of Medicare Beneficiaries With Medical Services | 201 |
| Total Medical Submitted Charge Amount | 66816.03 |
| Total Medical Medicare Allowed Amount | 61465.71 |
| Total Medical Medicare Payment Amount | 50149.73 |
| Total Medical Medicare Standardized Payment Amount | 46878.59 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 64 |
| Number Of Beneficiaries Age 65 to 74 | 70 |
| Number Of Beneficiaries Age 75 to 84 | 46 |
| Number Of Beneficiaries Age Greater 84 | 21 |
| Number Of Female Beneficiaries | 117 |
| Number Of Male Beneficiaries | 84 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 178 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 11 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 190 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 75 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.8536 |