| National Provider Identifier [NPI]: | 1306816657 |
| Last Name Of The Provider | BLOSE |
| First Name Of The Provider | DOUGLAS |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11525 BROOKSHIRE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | DOWNEY |
| Zip Code Of The Provider | 902414985 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 82 |
| Number Of Services | 8359 |
| Number Of Medicare Beneficiaries | 1074 |
| Total Submitted Charge Amount | 871933 |
| Total Medicare Allowed Amount | 599274.46 |
| Total Medicare Payment Amount | 460981.99 |
| Total Medicare Standardized Payment Amount | 397470.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1551 |
| Number Of Medicare Beneficiaries With Drug Services | 170 |
| Total Drug Submitted ChargeAmount | 10588 |
| Total Drug Medicare AllowedAmount | 2579.68 |
| Total Drug Medicare PaymentAmount | 1973.68 |
| Total Drug Medicare Standardized Payment Amount | 1973.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 77 |
| Number Of Medical Services | 6808 |
| Number Of Medicare Beneficiaries With Medical Services | 1074 |
| Total Medical Submitted Charge Amount | 861345 |
| Total Medical Medicare Allowed Amount | 596694.78 |
| Total Medical Medicare Payment Amount | 459008.31 |
| Total Medical Medicare Standardized Payment Amount | 395496.78 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 147 |
| Number Of Beneficiaries Age 65 to 74 | 359 |
| Number Of Beneficiaries Age 75 to 84 | 344 |
| Number Of Beneficiaries Age Greater 84 | 224 |
| Number Of Female Beneficiaries | 642 |
| Number Of Male Beneficiaries | 432 |
| Number Of Non Hispanic White Beneficiaries | 293 |
| Number Of Black or African American Beneficiaries | 42 |
| Number Of AsianPacific Islander Beneficiaries | 29 |
| Number Of Hispanic Beneficiaries | 696 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 359 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 715 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.6572 |