| National Provider Identifier [NPI]: | 1831131069 |
| Last Name Of The Provider | LO |
| First Name Of The Provider | JACOB |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD, MS, FAAD, FACMMS |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 665 MUNRAS AVE |
| Street Address 2 Of The Provider | SUITE200 |
| City Of The Provider | MONTEREY |
| Zip Code Of The Provider | 939403129 |
| 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 | 70 |
| Number Of Services | 6022 |
| Number Of Medicare Beneficiaries | 1170 |
| Total Submitted Charge Amount | 1145780.86 |
| Total Medicare Allowed Amount | 547355.82 |
| Total Medicare Payment Amount | 396114.39 |
| Total Medicare Standardized Payment Amount | 378015.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 16 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 320 |
| Total Drug Medicare AllowedAmount | 32.83 |
| Total Drug Medicare PaymentAmount | 21.4 |
| Total Drug Medicare Standardized Payment Amount | 21.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 6006 |
| Number Of Medicare Beneficiaries With Medical Services | 1170 |
| Total Medical Submitted Charge Amount | 1145460.86 |
| Total Medical Medicare Allowed Amount | 547322.99 |
| Total Medical Medicare Payment Amount | 396092.99 |
| Total Medical Medicare Standardized Payment Amount | 377993.99 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 619 |
| Number Of Beneficiaries Age 75 to 84 | 370 |
| Number Of Beneficiaries Age Greater 84 | 153 |
| Number Of Female Beneficiaries | 621 |
| Number Of Male Beneficiaries | 549 |
| Number Of Non Hispanic White Beneficiaries | 1070 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 34 |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1138 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 32 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.822 |