National Provider Identifier [NPI]: |
1801971262 |
Last Name Of The Provider |
KUMASAKA |
First Name Of The Provider |
BRIAN |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4011 TALBOT ROAD SOUTH |
Street Address 2 Of The Provider |
SUITE 460 |
City Of The Provider |
RENTON |
Zip Code Of The Provider |
98055 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
63 |
Number Of Services |
4830 |
Number Of Medicare Beneficiaries |
792 |
Total Submitted Charge Amount |
474988.69 |
Total Medicare Allowed Amount |
222252.07 |
Total Medicare Payment Amount |
159358.08 |
Total Medicare Standardized Payment Amount |
148224.26 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
338 |
Number Of Beneficiaries Age 75 to 84 |
292 |
Number Of Beneficiaries Age Greater 84 |
133 |
Number Of Female Beneficiaries |
362 |
Number Of Male Beneficiaries |
430 |
Number Of Non Hispanic White Beneficiaries |
722 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
38 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
21 |
Number Of Beneficiaries With Medicare Only Entitlement |
755 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
37 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0215 |