| National Provider Identifier [NPI]: | 1518958040 |
| Last Name Of The Provider | LOPEZ |
| First Name Of The Provider | ALFREDO |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2060 N SHADELAND AVE |
| Street Address 2 Of The Provider | STE 200 |
| City Of The Provider | INDIANAPOLIS |
| Zip Code Of The Provider | 462191764 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 111 |
| Number Of Services | 2404 |
| Number Of Medicare Beneficiaries | 111 |
| Total Submitted Charge Amount | 243488.3 |
| Total Medicare Allowed Amount | 96985 |
| Total Medicare Payment Amount | 70274.45 |
| Total Medicare Standardized Payment Amount | 72599.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 1090 |
| Number Of Medicare Beneficiaries With Drug Services | 77 |
| Total Drug Submitted ChargeAmount | 31586 |
| Total Drug Medicare AllowedAmount | 7812.14 |
| Total Drug Medicare PaymentAmount | 6095.14 |
| Total Drug Medicare Standardized Payment Amount | 6095.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 94 |
| Number Of Medical Services | 1314 |
| Number Of Medicare Beneficiaries With Medical Services | 111 |
| Total Medical Submitted Charge Amount | 211902.3 |
| Total Medical Medicare Allowed Amount | 89172.86 |
| Total Medical Medicare Payment Amount | 64179.31 |
| Total Medical Medicare Standardized Payment Amount | 66504.49 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 57 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 69 |
| Number Of Male Beneficiaries | 42 |
| Number Of Non Hispanic White Beneficiaries | 19 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 79 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 49 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 62 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9856 |