| National Provider Identifier [NPI]: | 1992891345 |
| Last Name Of The Provider | GOMEZ |
| First Name Of The Provider | WENDY |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 605A MEDICAL CENTER PKWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | BOAZ |
| Zip Code Of The Provider | 359575937 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 2849 |
| Number Of Medicare Beneficiaries | 245 |
| Total Submitted Charge Amount | 175142.84 |
| Total Medicare Allowed Amount | 125750.48 |
| Total Medicare Payment Amount | 90302.14 |
| Total Medicare Standardized Payment Amount | 98704.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 569 |
| Number Of Medicare Beneficiaries With Drug Services | 160 |
| Total Drug Submitted ChargeAmount | 10842.27 |
| Total Drug Medicare AllowedAmount | 2642.2 |
| Total Drug Medicare PaymentAmount | 2414.77 |
| Total Drug Medicare Standardized Payment Amount | 2414.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 2280 |
| Number Of Medicare Beneficiaries With Medical Services | 245 |
| Total Medical Submitted Charge Amount | 164300.57 |
| Total Medical Medicare Allowed Amount | 123108.28 |
| Total Medical Medicare Payment Amount | 87887.37 |
| Total Medical Medicare Standardized Payment Amount | 96289.55 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 53 |
| Number Of Beneficiaries Age 65 to 74 | 93 |
| Number Of Beneficiaries Age 75 to 84 | 69 |
| Number Of Beneficiaries Age Greater 84 | 30 |
| Number Of Female Beneficiaries | 171 |
| Number Of Male Beneficiaries | 74 |
| Number Of Non Hispanic White Beneficiaries | 233 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 153 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 92 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.2288 |