| National Provider Identifier [NPI]: | 1639255847 |
| Last Name Of The Provider | LAROSA |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6920 PARKDALE PLACE |
| Street Address 2 Of The Provider | #110 |
| City Of The Provider | INDPLS |
| Zip Code Of The Provider | 46254 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 15 |
| Number Of Services | 1992 |
| Number Of Medicare Beneficiaries | 640 |
| Total Submitted Charge Amount | 240255 |
| Total Medicare Allowed Amount | 195728.68 |
| Total Medicare Payment Amount | 135245.67 |
| Total Medicare Standardized Payment Amount | 145094.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 85 |
| Number Of Medicare Beneficiaries With Drug Services | 78 |
| Total Drug Submitted ChargeAmount | 1495 |
| Total Drug Medicare AllowedAmount | 1251.41 |
| Total Drug Medicare PaymentAmount | 1211.93 |
| Total Drug Medicare Standardized Payment Amount | 1211.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 12 |
| Number Of Medical Services | 1907 |
| Number Of Medicare Beneficiaries With Medical Services | 640 |
| Total Medical Submitted Charge Amount | 238760 |
| Total Medical Medicare Allowed Amount | 194477.27 |
| Total Medical Medicare Payment Amount | 134033.74 |
| Total Medical Medicare Standardized Payment Amount | 143882.35 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 156 |
| Number Of Beneficiaries Age 65 to 74 | 205 |
| Number Of Beneficiaries Age 75 to 84 | 169 |
| Number Of Beneficiaries Age Greater 84 | 110 |
| Number Of Female Beneficiaries | 392 |
| Number Of Male Beneficiaries | 248 |
| Number Of Non Hispanic White Beneficiaries | 554 |
| Number Of Black or African American Beneficiaries | 73 |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 361 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 279 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.6773 |