National Provider Identifier [NPI]: |
1396823167 |
Last Name Of The Provider |
KAO |
First Name Of The Provider |
SUSAN |
Middle Initial Of The Provider |
Y |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2001 DWIGHT WAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
BERKELEY |
Zip Code Of The Provider |
947042608 |
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 |
12 |
Number Of Services |
1261 |
Number Of Medicare Beneficiaries |
285 |
Total Submitted Charge Amount |
448722 |
Total Medicare Allowed Amount |
120327.04 |
Total Medicare Payment Amount |
89462.2 |
Total Medicare Standardized Payment Amount |
82361.67 |
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 |
12 |
Number Of Medical Services |
1261 |
Number Of Medicare Beneficiaries With Medical Services |
285 |
Total Medical Submitted Charge Amount |
448722 |
Total Medical Medicare Allowed Amount |
120327.04 |
Total Medical Medicare Payment Amount |
89462.2 |
Total Medical Medicare Standardized Payment Amount |
82361.67 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
114 |
Number Of Beneficiaries Age 75 to 84 |
98 |
Number Of Beneficiaries Age Greater 84 |
46 |
Number Of Female Beneficiaries |
161 |
Number Of Male Beneficiaries |
124 |
Number Of Non Hispanic White Beneficiaries |
122 |
Number Of Black or African American Beneficiaries |
56 |
Number Of AsianPacific Islander Beneficiaries |
85 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
161 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
124 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
45 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.2029 |