| National Provider Identifier [NPI]: | 1538101670 |
| Last Name Of The Provider | LY |
| First Name Of The Provider | LUONG |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 99 S RAYMOND AVE # 610 |
| Street Address 2 Of The Provider | |
| City Of The Provider | PASADENA |
| Zip Code Of The Provider | 911052046 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 5 |
| Number Of Services | 6356 |
| Number Of Medicare Beneficiaries | 937 |
| Total Submitted Charge Amount | 1036292 |
| Total Medicare Allowed Amount | 549568.36 |
| Total Medicare Payment Amount | 428639.4 |
| Total Medicare Standardized Payment Amount | 403655.8 |
| 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 | 5 |
| Number Of Medical Services | 6356 |
| Number Of Medicare Beneficiaries With Medical Services | 937 |
| Total Medical Submitted Charge Amount | 1036292 |
| Total Medical Medicare Allowed Amount | 549568.36 |
| Total Medical Medicare Payment Amount | 428639.4 |
| Total Medical Medicare Standardized Payment Amount | 403655.8 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 101 |
| Number Of Beneficiaries Age 65 to 74 | 160 |
| Number Of Beneficiaries Age 75 to 84 | 280 |
| Number Of Beneficiaries Age Greater 84 | 396 |
| Number Of Female Beneficiaries | 514 |
| Number Of Male Beneficiaries | 423 |
| Number Of Non Hispanic White Beneficiaries | 149 |
| Number Of Black or African American Beneficiaries | 21 |
| Number Of AsianPacific Islander Beneficiaries | 530 |
| Number Of Hispanic Beneficiaries | 217 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 153 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 784 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 63 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 67 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 61 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 71 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 25 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 22 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 3.8388 |