| National Provider Identifier [NPI]: | 1235113457 |
| Last Name Of The Provider | LAO |
| First Name Of The Provider | IRENE |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 931 BUENA VISTA ST |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | DUARTE |
| Zip Code Of The Provider | 910101712 |
| 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 | 45 |
| Number Of Services | 7327 |
| Number Of Medicare Beneficiaries | 1273 |
| Total Submitted Charge Amount | 506039 |
| Total Medicare Allowed Amount | 426175.22 |
| Total Medicare Payment Amount | 306295.09 |
| Total Medicare Standardized Payment Amount | 267918.64 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 45 |
| Number Of Beneficiaries Age 65 to 74 | 480 |
| Number Of Beneficiaries Age 75 to 84 | 475 |
| Number Of Beneficiaries Age Greater 84 | 273 |
| Number Of Female Beneficiaries | 750 |
| Number Of Male Beneficiaries | 523 |
| Number Of Non Hispanic White Beneficiaries | 1083 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | 58 |
| Number Of Hispanic Beneficiaries | 94 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1145 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 128 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0622 |