| National Provider Identifier [NPI]: | 1780620021 |
| Last Name Of The Provider | RO |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1045 W REDONDO BEACH BLVD |
| Street Address 2 Of The Provider | SUITE 240 |
| City Of The Provider | GARDENA |
| Zip Code Of The Provider | 902474128 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 3556 |
| Number Of Medicare Beneficiaries | 232 |
| Total Submitted Charge Amount | 89286 |
| Total Medicare Allowed Amount | 54028.41 |
| Total Medicare Payment Amount | 42107.87 |
| Total Medicare Standardized Payment Amount | 40286.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 26 |
| Number Of Drug Services | 2467 |
| Number Of Medicare Beneficiaries With Drug Services | 57 |
| Total Drug Submitted ChargeAmount | 46043 |
| Total Drug Medicare AllowedAmount | 26341.73 |
| Total Drug Medicare PaymentAmount | 21045.26 |
| Total Drug Medicare Standardized Payment Amount | 21045.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 1089 |
| Number Of Medicare Beneficiaries With Medical Services | 232 |
| Total Medical Submitted Charge Amount | 43243 |
| Total Medical Medicare Allowed Amount | 27686.68 |
| Total Medical Medicare Payment Amount | 21062.61 |
| Total Medical Medicare Standardized Payment Amount | 19241.31 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 13 |
| Number Of Beneficiaries Age 65 to 74 | 86 |
| Number Of Beneficiaries Age 75 to 84 | 79 |
| Number Of Beneficiaries Age Greater 84 | 54 |
| Number Of Female Beneficiaries | 107 |
| Number Of Male Beneficiaries | 125 |
| Number Of Non Hispanic White Beneficiaries | 170 |
| Number Of Black or African American Beneficiaries | 25 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 207 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 43 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3952 |