| National Provider Identifier [NPI]: | 1114960861 |
| Last Name Of The Provider | HIROSE |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 24445 HAWTHORNE BLVD |
| Street Address 2 Of The Provider | SUITE 206 |
| City Of The Provider | TORRANCE |
| Zip Code Of The Provider | 905056562 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 9 |
| Number Of Services | 3412 |
| Number Of Medicare Beneficiaries | 537 |
| Total Submitted Charge Amount | 918965.5 |
| Total Medicare Allowed Amount | 490742.45 |
| Total Medicare Payment Amount | 371355.47 |
| Total Medicare Standardized Payment Amount | 329195.3 |
| 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 | 9 |
| Number Of Medical Services | 3412 |
| Number Of Medicare Beneficiaries With Medical Services | 537 |
| Total Medical Submitted Charge Amount | 918965.5 |
| Total Medical Medicare Allowed Amount | 490742.45 |
| Total Medical Medicare Payment Amount | 371355.47 |
| Total Medical Medicare Standardized Payment Amount | 329195.3 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 156 |
| Number Of Beneficiaries Age 75 to 84 | 187 |
| Number Of Beneficiaries Age Greater 84 | 158 |
| Number Of Female Beneficiaries | 301 |
| Number Of Male Beneficiaries | 236 |
| Number Of Non Hispanic White Beneficiaries | 409 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 48 |
| Number Of Hispanic Beneficiaries | 43 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 432 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 105 |
| Percent Of With Atrial Fibrillation | 43 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 20 |
| Average HCC Risk Score Of Beneficiaries | 2.4828 |