| National Provider Identifier [NPI]: | 1619906104 |
| Last Name Of The Provider | GABRIEL |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1720 E CESAR E CHAVEZ AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900332414 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 152 |
| Number Of Services | 5249 |
| Number Of Medicare Beneficiaries | 3028 |
| Total Submitted Charge Amount | 512175 |
| Total Medicare Allowed Amount | 177230.72 |
| Total Medicare Payment Amount | 139014.88 |
| Total Medicare Standardized Payment Amount | 129173.17 |
| 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 | 152 |
| Number Of Medical Services | 5249 |
| Number Of Medicare Beneficiaries With Medical Services | 3028 |
| Total Medical Submitted Charge Amount | 512175 |
| Total Medical Medicare Allowed Amount | 177230.72 |
| Total Medical Medicare Payment Amount | 139014.88 |
| Total Medical Medicare Standardized Payment Amount | 129173.17 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 534 |
| Number Of Beneficiaries Age 65 to 74 | 1160 |
| Number Of Beneficiaries Age 75 to 84 | 879 |
| Number Of Beneficiaries Age Greater 84 | 455 |
| Number Of Female Beneficiaries | 1871 |
| Number Of Male Beneficiaries | 1157 |
| Number Of Non Hispanic White Beneficiaries | 816 |
| Number Of Black or African American Beneficiaries | 179 |
| Number Of AsianPacific Islander Beneficiaries | 306 |
| Number Of Hispanic Beneficiaries | 1669 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 851 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2177 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.3044 |