| National Provider Identifier [NPI]: | 1629144464 |
| Last Name Of The Provider | JAO |
| First Name Of The Provider | KEDY |
| Middle Initial Of The Provider | Y |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12675 LA MIRADA BLVD |
| Street Address 2 Of The Provider | #220 |
| City Of The Provider | LA MIRADA |
| Zip Code Of The Provider | 906382235 |
| 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 | 37 |
| Number Of Services | 832 |
| Number Of Medicare Beneficiaries | 174 |
| Total Submitted Charge Amount | 124798 |
| Total Medicare Allowed Amount | 90930.03 |
| Total Medicare Payment Amount | 64007.84 |
| Total Medicare Standardized Payment Amount | 58416.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 58 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 5490 |
| Total Drug Medicare AllowedAmount | 4257.31 |
| Total Drug Medicare PaymentAmount | 3576.76 |
| Total Drug Medicare Standardized Payment Amount | 3576.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 774 |
| Number Of Medicare Beneficiaries With Medical Services | 174 |
| Total Medical Submitted Charge Amount | 119308 |
| Total Medical Medicare Allowed Amount | 86672.72 |
| Total Medical Medicare Payment Amount | 60431.08 |
| Total Medical Medicare Standardized Payment Amount | 54839.39 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 83 |
| Number Of Beneficiaries Age 75 to 84 | 52 |
| Number Of Beneficiaries Age Greater 84 | 25 |
| Number Of Female Beneficiaries | 120 |
| Number Of Male Beneficiaries | 54 |
| Number Of Non Hispanic White Beneficiaries | 101 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 47 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 159 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 15 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1175 |