| National Provider Identifier [NPI]: | 1326139304 |
| Last Name Of The Provider | LATHAM |
| First Name Of The Provider | JOSHUA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 48 MDG |
| Street Address 2 Of The Provider | UNIT 5210 |
| City Of The Provider | APO |
| Zip Code Of The Provider | 09461 |
| State Code Of The Provider | AE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 414 |
| Number Of Medicare Beneficiaries | 125 |
| Total Submitted Charge Amount | 15688 |
| Total Medicare Allowed Amount | 8260.61 |
| Total Medicare Payment Amount | 6260.41 |
| Total Medicare Standardized Payment Amount | 6588.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 223 |
| Number Of Medicare Beneficiaries With Drug Services | 43 |
| Total Drug Submitted ChargeAmount | 1679 |
| Total Drug Medicare AllowedAmount | 182.88 |
| Total Drug Medicare PaymentAmount | 150.66 |
| Total Drug Medicare Standardized Payment Amount | 150.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 191 |
| Number Of Medicare Beneficiaries With Medical Services | 115 |
| Total Medical Submitted Charge Amount | 14009 |
| Total Medical Medicare Allowed Amount | 8077.73 |
| Total Medical Medicare Payment Amount | 6109.75 |
| Total Medical Medicare Standardized Payment Amount | 6438.1 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 49 |
| Number Of Beneficiaries Age 75 to 84 | 41 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 88 |
| Number Of Male Beneficiaries | 37 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 111 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 14 |
| 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 | 10 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9135 |