National Provider Identifier [NPI]: |
1528132214 |
Last Name Of The Provider |
LO |
First Name Of The Provider |
LAWRENCE |
Middle Initial Of The Provider |
Y |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
400 NEWPORT CENTER DR STE 301 |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEWPORT BEACH |
Zip Code Of The Provider |
926607604 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
680 |
Number Of Medicare Beneficiaries |
217 |
Total Submitted Charge Amount |
73499.31 |
Total Medicare Allowed Amount |
72908.06 |
Total Medicare Payment Amount |
49235 |
Total Medicare Standardized Payment Amount |
44303.49 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
17 |
Number Of Medicare Beneficiaries With Drug Services |
15 |
Total Drug Submitted ChargeAmount |
451.92 |
Total Drug Medicare AllowedAmount |
385.66 |
Total Drug Medicare PaymentAmount |
374.5 |
Total Drug Medicare Standardized Payment Amount |
374.5 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
16 |
Number Of Medical Services |
663 |
Number Of Medicare Beneficiaries With Medical Services |
217 |
Total Medical Submitted Charge Amount |
73047.39 |
Total Medical Medicare Allowed Amount |
72522.4 |
Total Medical Medicare Payment Amount |
48860.5 |
Total Medical Medicare Standardized Payment Amount |
43928.99 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
133 |
Number Of Beneficiaries Age 75 to 84 |
51 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
101 |
Number Of Male Beneficiaries |
116 |
Number Of Non Hispanic White Beneficiaries |
170 |
Number Of Black or African American Beneficiaries |
0 |
Number Of AsianPacific Islander Beneficiaries |
32 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
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 |
11 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
|
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
48 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9491 |