| National Provider Identifier [NPI]: | 1093871873 |
| Last Name Of The Provider | PO |
| First Name Of The Provider | JONATHAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 W CARSON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | TORRANCE |
| Zip Code Of The Provider | 905022004 |
| 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 | 121 |
| Number Of Services | 1714 |
| Number Of Medicare Beneficiaries | 1221 |
| Total Submitted Charge Amount | 292138.88 |
| Total Medicare Allowed Amount | 64989.82 |
| Total Medicare Payment Amount | 49583.05 |
| Total Medicare Standardized Payment Amount | 47380.95 |
| 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 | 121 |
| Number Of Medical Services | 1714 |
| Number Of Medicare Beneficiaries With Medical Services | 1221 |
| Total Medical Submitted Charge Amount | 292138.88 |
| Total Medical Medicare Allowed Amount | 64989.82 |
| Total Medical Medicare Payment Amount | 49583.05 |
| Total Medical Medicare Standardized Payment Amount | 47380.95 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 113 |
| Number Of Beneficiaries Age 65 to 74 | 409 |
| Number Of Beneficiaries Age 75 to 84 | 429 |
| Number Of Beneficiaries Age Greater 84 | 270 |
| Number Of Female Beneficiaries | 653 |
| Number Of Male Beneficiaries | 568 |
| Number Of Non Hispanic White Beneficiaries | 753 |
| Number Of Black or African American Beneficiaries | 107 |
| Number Of AsianPacific Islander Beneficiaries | 167 |
| Number Of Hispanic Beneficiaries | 156 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 919 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 302 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.0607 |