| National Provider Identifier [NPI]: | 1245397694 |
| Last Name Of The Provider | GOMEZ-VAZQUEZ |
| First Name Of The Provider | ROBERTO |
| 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 | 7210 MCPHERSON RD |
| Street Address 2 Of The Provider | STE.115 |
| City Of The Provider | LAREDO |
| Zip Code Of The Provider | 780416507 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 128 |
| Number Of Services | 759 |
| Number Of Medicare Beneficiaries | 292 |
| Total Submitted Charge Amount | 554498.54 |
| Total Medicare Allowed Amount | 178526.79 |
| Total Medicare Payment Amount | 137250.09 |
| Total Medicare Standardized Payment Amount | 144630.33 |
| 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 | 128 |
| Number Of Medical Services | 759 |
| Number Of Medicare Beneficiaries With Medical Services | 292 |
| Total Medical Submitted Charge Amount | 554498.54 |
| Total Medical Medicare Allowed Amount | 178526.79 |
| Total Medical Medicare Payment Amount | 137250.09 |
| Total Medical Medicare Standardized Payment Amount | 144630.33 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 58 |
| Number Of Beneficiaries Age 65 to 74 | 101 |
| Number Of Beneficiaries Age 75 to 84 | 85 |
| Number Of Beneficiaries Age Greater 84 | 48 |
| Number Of Female Beneficiaries | 182 |
| Number Of Male Beneficiaries | 110 |
| Number Of Non Hispanic White Beneficiaries | 23 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 269 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 114 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 178 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 62 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.9343 |