| National Provider Identifier [NPI]: | 1285769182 |
| Last Name Of The Provider | LAU |
| First Name Of The Provider | JACOB |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2811 N VENTURA RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | OXNARD |
| Zip Code Of The Provider | 930362213 |
| 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 | 86 |
| Number Of Services | 6971 |
| Number Of Medicare Beneficiaries | 1119 |
| Total Submitted Charge Amount | 746571 |
| Total Medicare Allowed Amount | 579237.54 |
| Total Medicare Payment Amount | 421246.38 |
| Total Medicare Standardized Payment Amount | 372106.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 866 |
| Number Of Medicare Beneficiaries With Drug Services | 115 |
| Total Drug Submitted ChargeAmount | 4410 |
| Total Drug Medicare AllowedAmount | 1605.64 |
| Total Drug Medicare PaymentAmount | 1142.6 |
| Total Drug Medicare Standardized Payment Amount | 1142.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 84 |
| Number Of Medical Services | 6105 |
| Number Of Medicare Beneficiaries With Medical Services | 1119 |
| Total Medical Submitted Charge Amount | 742161 |
| Total Medical Medicare Allowed Amount | 577631.9 |
| Total Medical Medicare Payment Amount | 420103.78 |
| Total Medical Medicare Standardized Payment Amount | 370963.66 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 63 |
| Number Of Beneficiaries Age 65 to 74 | 509 |
| Number Of Beneficiaries Age 75 to 84 | 377 |
| Number Of Beneficiaries Age Greater 84 | 170 |
| Number Of Female Beneficiaries | 562 |
| Number Of Male Beneficiaries | 557 |
| Number Of Non Hispanic White Beneficiaries | 909 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 36 |
| Number Of Hispanic Beneficiaries | 130 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1010 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 109 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0732 |