National Provider Identifier [NPI]: |
1528132552 |
Last Name Of The Provider |
KAKISHIBA |
First Name Of The Provider |
KAREN |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
810 RICHLAND ROAD |
Street Address 2 Of The Provider |
|
City Of The Provider |
YUBA CITY |
Zip Code Of The Provider |
95991 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
288 |
Number Of Medicare Beneficiaries |
169 |
Total Submitted Charge Amount |
22804 |
Total Medicare Allowed Amount |
22302.93 |
Total Medicare Payment Amount |
13150.42 |
Total Medicare Standardized Payment Amount |
12726.47 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
40 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
152 |
Total Drug Medicare AllowedAmount |
61.02 |
Total Drug Medicare PaymentAmount |
46.25 |
Total Drug Medicare Standardized Payment Amount |
46.25 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
248 |
Number Of Medicare Beneficiaries With Medical Services |
169 |
Total Medical Submitted Charge Amount |
22652 |
Total Medical Medicare Allowed Amount |
22241.91 |
Total Medical Medicare Payment Amount |
13104.17 |
Total Medical Medicare Standardized Payment Amount |
12680.22 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
62 |
Number Of Beneficiaries Age 75 to 84 |
59 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
127 |
Number Of Male Beneficiaries |
42 |
Number Of Non Hispanic White Beneficiaries |
140 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
12 |
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 |
141 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9854 |