| National Provider Identifier [NPI]: | 1548291180 |
| Last Name Of The Provider | TAW |
| First Name Of The Provider | LAWRENCE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 MED PLZ |
| Street Address 2 Of The Provider | SUITE# 365 |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900950001 |
| 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 | 7 |
| Number Of Services | 3673 |
| Number Of Medicare Beneficiaries | 296 |
| Total Submitted Charge Amount | 726247 |
| Total Medicare Allowed Amount | 245903.85 |
| Total Medicare Payment Amount | 185875.92 |
| Total Medicare Standardized Payment Amount | 170995.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 7 |
| Number Of Medical Services | 3673 |
| Number Of Medicare Beneficiaries With Medical Services | 296 |
| Total Medical Submitted Charge Amount | 726247 |
| Total Medical Medicare Allowed Amount | 245903.85 |
| Total Medical Medicare Payment Amount | 185875.92 |
| Total Medical Medicare Standardized Payment Amount | 170995.21 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 64 |
| Number Of Beneficiaries Age 65 to 74 | 118 |
| Number Of Beneficiaries Age 75 to 84 | 77 |
| Number Of Beneficiaries Age Greater 84 | 37 |
| Number Of Female Beneficiaries | 216 |
| Number Of Male Beneficiaries | 80 |
| Number Of Non Hispanic White Beneficiaries | 187 |
| Number Of Black or African American Beneficiaries | 29 |
| Number Of AsianPacific Islander Beneficiaries | 35 |
| Number Of Hispanic Beneficiaries | 30 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 203 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 93 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 74 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3214 |