| National Provider Identifier [NPI]: | 1861487407 |
| Last Name Of The Provider | TOM |
| First Name Of The Provider | LAURIE |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1380 LUSITANA ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | HONOLULU |
| Zip Code Of The Provider | 968132444 |
| State Code Of The Provider | HI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 12 |
| Number Of Services | 1865 |
| Number Of Medicare Beneficiaries | 352 |
| Total Submitted Charge Amount | 124160.12 |
| Total Medicare Allowed Amount | 94780.36 |
| Total Medicare Payment Amount | 64871.85 |
| Total Medicare Standardized Payment Amount | 64318.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 13 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 188.89 |
| Total Drug Medicare AllowedAmount | 156.52 |
| Total Drug Medicare PaymentAmount | 153.4 |
| Total Drug Medicare Standardized Payment Amount | 153.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 11 |
| Number Of Medical Services | 1852 |
| Number Of Medicare Beneficiaries With Medical Services | 352 |
| Total Medical Submitted Charge Amount | 123971.23 |
| Total Medical Medicare Allowed Amount | 94623.84 |
| Total Medical Medicare Payment Amount | 64718.45 |
| Total Medical Medicare Standardized Payment Amount | 64164.82 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 167 |
| Number Of Beneficiaries Age 75 to 84 | 127 |
| Number Of Beneficiaries Age Greater 84 | 39 |
| Number Of Female Beneficiaries | 219 |
| Number Of Male Beneficiaries | 133 |
| Number Of Non Hispanic White Beneficiaries | 54 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 234 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 52 |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 68 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.2432 |