| National Provider Identifier [NPI]: | 1376651117 |
| Last Name Of The Provider | LOZANO |
| First Name Of The Provider | IVETTE |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10425 GARLAND RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 752182926 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 1352 |
| Number Of Medicare Beneficiaries | 67 |
| Total Submitted Charge Amount | 98553 |
| Total Medicare Allowed Amount | 72312.38 |
| Total Medicare Payment Amount | 54237.48 |
| Total Medicare Standardized Payment Amount | 53967.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 253 |
| Number Of Medicare Beneficiaries With Drug Services | 49 |
| Total Drug Submitted ChargeAmount | 11265 |
| Total Drug Medicare AllowedAmount | 1168.9 |
| Total Drug Medicare PaymentAmount | 988.53 |
| Total Drug Medicare Standardized Payment Amount | 988.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 1099 |
| Number Of Medicare Beneficiaries With Medical Services | 67 |
| Total Medical Submitted Charge Amount | 87288 |
| Total Medical Medicare Allowed Amount | 71143.48 |
| Total Medical Medicare Payment Amount | 53248.95 |
| Total Medical Medicare Standardized Payment Amount | 52979.24 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 28 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 46 |
| Number Of Male Beneficiaries | 21 |
| Number Of Non Hispanic White Beneficiaries | 41 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| 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 | 18 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | |
| Percent Of With Diabetes | 75 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1066 |