| National Provider Identifier [NPI]: | 1225046527 |
| Last Name Of The Provider | KISHIYAMA |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4050 MOORPARK AVENUE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN JOSE |
| Zip Code Of The Provider | 951171840 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Allergy/Immunology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 5489 |
| Number Of Medicare Beneficiaries | 176 |
| Total Submitted Charge Amount | 180677 |
| Total Medicare Allowed Amount | 95536.84 |
| Total Medicare Payment Amount | 70805.96 |
| Total Medicare Standardized Payment Amount | 69070.86 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 642 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 26068 |
| Total Drug Medicare AllowedAmount | 16475.77 |
| Total Drug Medicare PaymentAmount | 12945.97 |
| Total Drug Medicare Standardized Payment Amount | 12945.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 4847 |
| Number Of Medicare Beneficiaries With Medical Services | 176 |
| Total Medical Submitted Charge Amount | 154609 |
| Total Medical Medicare Allowed Amount | 79061.07 |
| Total Medical Medicare Payment Amount | 57859.99 |
| Total Medical Medicare Standardized Payment Amount | 56124.89 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 89 |
| Number Of Beneficiaries Age 75 to 84 | 49 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 122 |
| Number Of Male Beneficiaries | 54 |
| Number Of Non Hispanic White Beneficiaries | 130 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 153 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 51 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8215 |