| National Provider Identifier [NPI]: | 1740212851 |
| Last Name Of The Provider | KAWAKAMI |
| First Name Of The Provider | SUSAN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8556 FLORENCE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | DOWNEY |
| Zip Code Of The Provider | 902404015 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 1214.5 |
| Number Of Medicare Beneficiaries | 96 |
| Total Submitted Charge Amount | 73569.55 |
| Total Medicare Allowed Amount | 68712.61 |
| Total Medicare Payment Amount | 55591.59 |
| Total Medicare Standardized Payment Amount | 51331.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 211.5 |
| Number Of Medicare Beneficiaries With Drug Services | 55 |
| Total Drug Submitted ChargeAmount | 8645.01 |
| Total Drug Medicare AllowedAmount | 5038.62 |
| Total Drug Medicare PaymentAmount | 4590.81 |
| Total Drug Medicare Standardized Payment Amount | 4590.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 1003 |
| Number Of Medicare Beneficiaries With Medical Services | 96 |
| Total Medical Submitted Charge Amount | 64924.54 |
| Total Medical Medicare Allowed Amount | 63673.99 |
| Total Medical Medicare Payment Amount | 51000.78 |
| Total Medical Medicare Standardized Payment Amount | 46740.98 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 37 |
| Number Of Beneficiaries Age 75 to 84 | 23 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 73 |
| Number Of Male Beneficiaries | 23 |
| Number Of Non Hispanic White Beneficiaries | 32 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 46 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 48 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 48 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 23 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.6782 |