| National Provider Identifier [NPI]: | 1184837098 |
| Last Name Of The Provider | TESHIMA |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 24331 EL TORO ROAD, SUITE 370 |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAGUNA WOODS |
| Zip Code Of The Provider | 926373104 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 5 |
| Number Of Services | 2484 |
| Number Of Medicare Beneficiaries | 512 |
| Total Submitted Charge Amount | 254434 |
| Total Medicare Allowed Amount | 231270.67 |
| Total Medicare Payment Amount | 174906.89 |
| Total Medicare Standardized Payment Amount | 160750.59 |
| 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 | 5 |
| Number Of Medical Services | 2484 |
| Number Of Medicare Beneficiaries With Medical Services | 512 |
| Total Medical Submitted Charge Amount | 254434 |
| Total Medical Medicare Allowed Amount | 231270.67 |
| Total Medical Medicare Payment Amount | 174906.89 |
| Total Medical Medicare Standardized Payment Amount | 160750.59 |
| Average Age Of Beneficiaries | 88 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | 91 |
| Number Of Beneficiaries Age Greater 84 | 381 |
| Number Of Female Beneficiaries | 383 |
| Number Of Male Beneficiaries | 129 |
| Number Of Non Hispanic White Beneficiaries | 59 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 402 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 255 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 257 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 60 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 29 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5454 |