| National Provider Identifier [NPI]: | 1477692333 |
| Last Name Of The Provider | OHRI |
| First Name Of The Provider | KUSUM |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1310 W. STEWART DR. |
| Street Address 2 Of The Provider | SUITE 602 |
| City Of The Provider | ORANGE |
| Zip Code Of The Provider | 928683854 |
| 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 | 40 |
| Number Of Services | 1680 |
| Number Of Medicare Beneficiaries | 289 |
| Total Submitted Charge Amount | 144791 |
| Total Medicare Allowed Amount | 112618.81 |
| Total Medicare Payment Amount | 85179.79 |
| Total Medicare Standardized Payment Amount | 76485.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 331 |
| Number Of Medicare Beneficiaries With Drug Services | 124 |
| Total Drug Submitted ChargeAmount | 9375 |
| Total Drug Medicare AllowedAmount | 8074.86 |
| Total Drug Medicare PaymentAmount | 7398.56 |
| Total Drug Medicare Standardized Payment Amount | 7398.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 1349 |
| Number Of Medicare Beneficiaries With Medical Services | 289 |
| Total Medical Submitted Charge Amount | 135416 |
| Total Medical Medicare Allowed Amount | 104543.95 |
| Total Medical Medicare Payment Amount | 77781.23 |
| Total Medical Medicare Standardized Payment Amount | 69087.35 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 133 |
| Number Of Beneficiaries Age 75 to 84 | 93 |
| Number Of Beneficiaries Age Greater 84 | 47 |
| Number Of Female Beneficiaries | 224 |
| Number Of Male Beneficiaries | 65 |
| Number Of Non Hispanic White Beneficiaries | 205 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 33 |
| Number Of Hispanic Beneficiaries | 36 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 245 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 44 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1178 |