| National Provider Identifier [NPI]: | 1952618316 |
| Last Name Of The Provider | GOMEZ |
| First Name Of The Provider | MELJUN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | NP-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2266 N LINCOLN AVE LOWR LEVEL |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606147600 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 6 |
| Number Of Services | 8372 |
| Number Of Medicare Beneficiaries | 525 |
| Total Submitted Charge Amount | 651190 |
| Total Medicare Allowed Amount | 615086.97 |
| Total Medicare Payment Amount | 468599.54 |
| Total Medicare Standardized Payment Amount | 522745.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 6 |
| Number Of Medical Services | 8372 |
| Number Of Medicare Beneficiaries With Medical Services | 525 |
| Total Medical Submitted Charge Amount | 651190 |
| Total Medical Medicare Allowed Amount | 615086.97 |
| Total Medical Medicare Payment Amount | 468599.54 |
| Total Medical Medicare Standardized Payment Amount | 522745.48 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 210 |
| Number Of Beneficiaries Age 65 to 74 | 141 |
| Number Of Beneficiaries Age 75 to 84 | 110 |
| Number Of Beneficiaries Age Greater 84 | 64 |
| Number Of Female Beneficiaries | 277 |
| Number Of Male Beneficiaries | 248 |
| Number Of Non Hispanic White Beneficiaries | 242 |
| Number Of Black or African American Beneficiaries | 212 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 58 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 126 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 399 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 31 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 59 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 23 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8704 |