| National Provider Identifier [NPI]: | 1396773362 |
| Last Name Of The Provider | GOMEZ |
| First Name Of The Provider | HENRY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1983 MARCUS AVE |
| Street Address 2 Of The Provider | SUITE E 124 |
| City Of The Provider | LAKE SUCCESS |
| Zip Code Of The Provider | 11042 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 4075 |
| Number Of Medicare Beneficiaries | 668 |
| Total Submitted Charge Amount | 454907.98 |
| Total Medicare Allowed Amount | 423206.67 |
| Total Medicare Payment Amount | 314886.83 |
| Total Medicare Standardized Payment Amount | 271899.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 267 |
| Number Of Medicare Beneficiaries With Drug Services | 182 |
| Total Drug Submitted ChargeAmount | 9226.45 |
| Total Drug Medicare AllowedAmount | 5948.9 |
| Total Drug Medicare PaymentAmount | 5791.64 |
| Total Drug Medicare Standardized Payment Amount | 5791.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 3808 |
| Number Of Medicare Beneficiaries With Medical Services | 668 |
| Total Medical Submitted Charge Amount | 445681.53 |
| Total Medical Medicare Allowed Amount | 417257.77 |
| Total Medical Medicare Payment Amount | 309095.19 |
| Total Medical Medicare Standardized Payment Amount | 266107.61 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 37 |
| Number Of Beneficiaries Age 65 to 74 | 300 |
| Number Of Beneficiaries Age 75 to 84 | 223 |
| Number Of Beneficiaries Age Greater 84 | 108 |
| Number Of Female Beneficiaries | 347 |
| Number Of Male Beneficiaries | 321 |
| Number Of Non Hispanic White Beneficiaries | 545 |
| Number Of Black or African American Beneficiaries | 32 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | 54 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 625 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 43 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.381 |