| National Provider Identifier [NPI]: | 1457398406 |
| Last Name Of The Provider | LAI |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1500 SOUTHGATE AVE |
| Street Address 2 Of The Provider | SUITE 115 |
| City Of The Provider | DALY CITY |
| Zip Code Of The Provider | 940152259 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 2259 |
| Number Of Medicare Beneficiaries | 460 |
| Total Submitted Charge Amount | 288791.16 |
| Total Medicare Allowed Amount | 224379.74 |
| Total Medicare Payment Amount | 169451.09 |
| Total Medicare Standardized Payment Amount | 151235.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 103 |
| Number Of Medicare Beneficiaries With Drug Services | 95 |
| Total Drug Submitted ChargeAmount | 3115 |
| Total Drug Medicare AllowedAmount | 1132.49 |
| Total Drug Medicare PaymentAmount | 1100.49 |
| Total Drug Medicare Standardized Payment Amount | 1100.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 2156 |
| Number Of Medicare Beneficiaries With Medical Services | 460 |
| Total Medical Submitted Charge Amount | 285676.16 |
| Total Medical Medicare Allowed Amount | 223247.25 |
| Total Medical Medicare Payment Amount | 168350.6 |
| Total Medical Medicare Standardized Payment Amount | 150135.43 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 49 |
| Number Of Beneficiaries Age 65 to 74 | 161 |
| Number Of Beneficiaries Age 75 to 84 | 131 |
| Number Of Beneficiaries Age Greater 84 | 119 |
| Number Of Female Beneficiaries | 255 |
| Number Of Male Beneficiaries | 205 |
| Number Of Non Hispanic White Beneficiaries | 134 |
| Number Of Black or African American Beneficiaries | 38 |
| Number Of AsianPacific Islander Beneficiaries | 194 |
| Number Of Hispanic Beneficiaries | 78 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 223 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 237 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.8529 |