| National Provider Identifier [NPI]: | 1619141223 |
| Last Name Of The Provider | LUE |
| First Name Of The Provider | JASON |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 238 S ARROYO PKWY |
| Street Address 2 Of The Provider | UNIT 408 |
| City Of The Provider | PASADENA |
| Zip Code Of The Provider | 911054133 |
| 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 | 142 |
| Number Of Services | 5762 |
| Number Of Medicare Beneficiaries | 2596 |
| Total Submitted Charge Amount | 491658.6 |
| Total Medicare Allowed Amount | 128760.97 |
| Total Medicare Payment Amount | 93928.98 |
| Total Medicare Standardized Payment Amount | 89196.42 |
| 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 | 142 |
| Number Of Medical Services | 5762 |
| Number Of Medicare Beneficiaries With Medical Services | 2596 |
| Total Medical Submitted Charge Amount | 491658.6 |
| Total Medical Medicare Allowed Amount | 128760.97 |
| Total Medical Medicare Payment Amount | 93928.98 |
| Total Medical Medicare Standardized Payment Amount | 89196.42 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 587 |
| Number Of Beneficiaries Age 65 to 74 | 804 |
| Number Of Beneficiaries Age 75 to 84 | 716 |
| Number Of Beneficiaries Age Greater 84 | 489 |
| Number Of Female Beneficiaries | 1463 |
| Number Of Male Beneficiaries | 1133 |
| Number Of Non Hispanic White Beneficiaries | 535 |
| Number Of Black or African American Beneficiaries | 471 |
| Number Of AsianPacific Islander Beneficiaries | 87 |
| Number Of Hispanic Beneficiaries | 1402 |
| Number Of American Indian Alaska Native Beneficiaries | 77 |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 524 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2072 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 34 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 52 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 62 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 17 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.8357 |