| National Provider Identifier [NPI]: | 1811131105 |
| Last Name Of The Provider | GOMEZ |
| First Name Of The Provider | IRAN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3690 MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BRIDGEPORT |
| Zip Code Of The Provider | 066063610 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 2095 |
| Number Of Medicare Beneficiaries | 503 |
| Total Submitted Charge Amount | 238278.5 |
| Total Medicare Allowed Amount | 169136.64 |
| Total Medicare Payment Amount | 124241.32 |
| Total Medicare Standardized Payment Amount | 116927.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 112 |
| Number Of Medicare Beneficiaries With Drug Services | 81 |
| Total Drug Submitted ChargeAmount | 4460 |
| Total Drug Medicare AllowedAmount | 2308.16 |
| Total Drug Medicare PaymentAmount | 2242.2 |
| Total Drug Medicare Standardized Payment Amount | 2242.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 1983 |
| Number Of Medicare Beneficiaries With Medical Services | 503 |
| Total Medical Submitted Charge Amount | 233818.5 |
| Total Medical Medicare Allowed Amount | 166828.48 |
| Total Medical Medicare Payment Amount | 121999.12 |
| Total Medical Medicare Standardized Payment Amount | 114685.7 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 77 |
| Number Of Beneficiaries Age 65 to 74 | 139 |
| Number Of Beneficiaries Age 75 to 84 | 148 |
| Number Of Beneficiaries Age Greater 84 | 139 |
| Number Of Female Beneficiaries | 307 |
| Number Of Male Beneficiaries | 196 |
| Number Of Non Hispanic White Beneficiaries | 259 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 166 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 175 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 328 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 37 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.8934 |