| National Provider Identifier [NPI]: | 1114113495 |
| Last Name Of The Provider | KAAWALOA |
| First Name Of The Provider | JEREM |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 868 ULULANI ST |
| Street Address 2 Of The Provider | SUITE 106 |
| City Of The Provider | HILO |
| Zip Code Of The Provider | 967203913 |
| State Code Of The Provider | HI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 17 |
| Number Of Services | 498 |
| Number Of Medicare Beneficiaries | 74 |
| Total Submitted Charge Amount | 42790.37 |
| Total Medicare Allowed Amount | 34633.95 |
| Total Medicare Payment Amount | 25697.63 |
| Total Medicare Standardized Payment Amount | 24129.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 63 |
| Number Of Medicare Beneficiaries With Drug Services | 44 |
| Total Drug Submitted ChargeAmount | 1778.62 |
| Total Drug Medicare AllowedAmount | 967.14 |
| Total Drug Medicare PaymentAmount | 941.92 |
| Total Drug Medicare Standardized Payment Amount | 941.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 12 |
| Number Of Medical Services | 435 |
| Number Of Medicare Beneficiaries With Medical Services | 74 |
| Total Medical Submitted Charge Amount | 41011.75 |
| Total Medical Medicare Allowed Amount | 33666.81 |
| Total Medical Medicare Payment Amount | 24755.71 |
| Total Medical Medicare Standardized Payment Amount | 23187.92 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 39 |
| Number Of Beneficiaries Age 75 to 84 | 21 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 42 |
| Number Of Male Beneficiaries | 32 |
| Number Of Non Hispanic White Beneficiaries | 29 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 23 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2943 |