| National Provider Identifier [NPI]: | 1407920713 |
| Last Name Of The Provider | LATIMORE |
| First Name Of The Provider | DARIN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4610 X ST STE 4101 |
| Street Address 2 Of The Provider | |
| City Of The Provider | SACRAMENTO |
| Zip Code Of The Provider | 958172200 |
| 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 | 18 |
| Number Of Services | 338 |
| Number Of Medicare Beneficiaries | 56 |
| Total Submitted Charge Amount | 23712.25 |
| Total Medicare Allowed Amount | 11412.4 |
| Total Medicare Payment Amount | 6877.62 |
| Total Medicare Standardized Payment Amount | 6636.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 201 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 2822.38 |
| Total Drug Medicare AllowedAmount | 1559.15 |
| Total Drug Medicare PaymentAmount | 1217.56 |
| Total Drug Medicare Standardized Payment Amount | 1217.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 11 |
| Number Of Medical Services | 137 |
| Number Of Medicare Beneficiaries With Medical Services | 56 |
| Total Medical Submitted Charge Amount | 20889.87 |
| Total Medical Medicare Allowed Amount | 9853.25 |
| Total Medical Medicare Payment Amount | 5660.06 |
| Total Medical Medicare Standardized Payment Amount | 5418.6 |
| Average Age Of Beneficiaries | 52 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | 35 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 12 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 44 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 52 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 21 |
| Percent Of With Hypertension | 43 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.767 |