| National Provider Identifier [NPI]: | 1942281696 |
| Last Name Of The Provider | IWAMOTO |
| First Name Of The Provider | MAMI |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 50 STANIFORD ST |
| Street Address 2 Of The Provider | SUITE 600 |
| City Of The Provider | BOSTON |
| Zip Code Of The Provider | 021142517 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 11428 |
| Number Of Medicare Beneficiaries | 818 |
| Total Submitted Charge Amount | 1103793 |
| Total Medicare Allowed Amount | 349939.86 |
| Total Medicare Payment Amount | 263677.75 |
| Total Medicare Standardized Payment Amount | 237057.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 9473 |
| Number Of Medicare Beneficiaries With Drug Services | 73 |
| Total Drug Submitted ChargeAmount | 56766 |
| Total Drug Medicare AllowedAmount | 51955.05 |
| Total Drug Medicare PaymentAmount | 40722.41 |
| Total Drug Medicare Standardized Payment Amount | 40722.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 64 |
| Number Of Medical Services | 1955 |
| Number Of Medicare Beneficiaries With Medical Services | 818 |
| Total Medical Submitted Charge Amount | 1047027 |
| Total Medical Medicare Allowed Amount | 297984.81 |
| Total Medical Medicare Payment Amount | 222955.34 |
| Total Medical Medicare Standardized Payment Amount | 196334.96 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 301 |
| Number Of Beneficiaries Age 75 to 84 | 327 |
| Number Of Beneficiaries Age Greater 84 | 168 |
| Number Of Female Beneficiaries | 519 |
| Number Of Male Beneficiaries | 299 |
| Number Of Non Hispanic White Beneficiaries | 790 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 768 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 50 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0507 |