| National Provider Identifier [NPI]: | 1386689453 |
| Last Name Of The Provider | DIEGO |
| First Name Of The Provider | LORAINE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2405 W 8TH ST |
| Street Address 2 Of The Provider | SUITE #105 |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900575016 |
| 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 | 33 |
| Number Of Services | 2386 |
| Number Of Medicare Beneficiaries | 510 |
| Total Submitted Charge Amount | 316725 |
| Total Medicare Allowed Amount | 226592.73 |
| Total Medicare Payment Amount | 170797.1 |
| Total Medicare Standardized Payment Amount | 151415.86 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 206 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 5150 |
| Total Drug Medicare AllowedAmount | 2989.78 |
| Total Drug Medicare PaymentAmount | 2422.25 |
| Total Drug Medicare Standardized Payment Amount | 2422.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 2180 |
| Number Of Medicare Beneficiaries With Medical Services | 510 |
| Total Medical Submitted Charge Amount | 311575 |
| Total Medical Medicare Allowed Amount | 223602.95 |
| Total Medical Medicare Payment Amount | 168374.85 |
| Total Medical Medicare Standardized Payment Amount | 148993.61 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 210 |
| Number Of Beneficiaries Age 65 to 74 | 161 |
| Number Of Beneficiaries Age 75 to 84 | 98 |
| Number Of Beneficiaries Age Greater 84 | 41 |
| Number Of Female Beneficiaries | 222 |
| Number Of Male Beneficiaries | 288 |
| Number Of Non Hispanic White Beneficiaries | 282 |
| Number Of Black or African American Beneficiaries | 85 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 103 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 35 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 475 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 52 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 65 |
| Percent Of With Depression | 69 |
| Percent Of With Diabetes | 58 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 75 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.6132 |