| National Provider Identifier [NPI]: | 1437178274 |
| Last Name Of The Provider | LA |
| First Name Of The Provider | DAN |
| 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 | 801 S CHEVY CHASE DR |
| Street Address 2 Of The Provider | 101 |
| City Of The Provider | GLENDALE |
| Zip Code Of The Provider | 912054431 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 30156 |
| Number Of Medicare Beneficiaries | 974 |
| Total Submitted Charge Amount | 1980439.71 |
| Total Medicare Allowed Amount | 854310.36 |
| Total Medicare Payment Amount | 661058.08 |
| Total Medicare Standardized Payment Amount | 624192.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 24107 |
| Number Of Medicare Beneficiaries With Drug Services | 351 |
| Total Drug Submitted ChargeAmount | 596774.71 |
| Total Drug Medicare AllowedAmount | 294701.28 |
| Total Drug Medicare PaymentAmount | 230790.68 |
| Total Drug Medicare Standardized Payment Amount | 230790.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 6049 |
| Number Of Medicare Beneficiaries With Medical Services | 974 |
| Total Medical Submitted Charge Amount | 1383665 |
| Total Medical Medicare Allowed Amount | 559609.08 |
| Total Medical Medicare Payment Amount | 430267.4 |
| Total Medical Medicare Standardized Payment Amount | 393401.79 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 163 |
| Number Of Beneficiaries Age 65 to 74 | 378 |
| Number Of Beneficiaries Age 75 to 84 | 312 |
| Number Of Beneficiaries Age Greater 84 | 121 |
| Number Of Female Beneficiaries | 718 |
| Number Of Male Beneficiaries | 256 |
| Number Of Non Hispanic White Beneficiaries | 598 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 85 |
| Number Of Hispanic Beneficiaries | 216 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 46 |
| Number Of Beneficiaries With Medicare Only Entitlement | 368 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 606 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 31 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5778 |