National Provider Identifier [NPI]: |
1639192602 |
Last Name Of The Provider |
SAKURAI |
First Name Of The Provider |
NAO |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
230 MAPLE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
HOLYOKE |
Zip Code Of The Provider |
010405144 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
1256 |
Number Of Medicare Beneficiaries |
304 |
Total Submitted Charge Amount |
31169 |
Total Medicare Allowed Amount |
18455.99 |
Total Medicare Payment Amount |
16456.1 |
Total Medicare Standardized Payment Amount |
18088.84 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
158 |
Number Of Medicare Beneficiaries With Drug Services |
136 |
Total Drug Submitted ChargeAmount |
4009 |
Total Drug Medicare AllowedAmount |
3593.8 |
Total Drug Medicare PaymentAmount |
3521.6 |
Total Drug Medicare Standardized Payment Amount |
3521.6 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
1098 |
Number Of Medicare Beneficiaries With Medical Services |
301 |
Total Medical Submitted Charge Amount |
27160 |
Total Medical Medicare Allowed Amount |
14862.19 |
Total Medical Medicare Payment Amount |
12934.5 |
Total Medical Medicare Standardized Payment Amount |
14567.24 |
Average Age Of Beneficiaries |
59 |
Number Of Beneficiaries Age Less65 |
182 |
Number Of Beneficiaries Age 65 to 74 |
97 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
145 |
Number Of Male Beneficiaries |
159 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
256 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
26 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
278 |
Percent Of With Atrial Fibrillation |
4 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
57 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
23 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.3791 |