National Provider Identifier [NPI]: |
1780851899 |
Last Name Of The Provider |
KOBASHI |
First Name Of The Provider |
BRENT |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1701 DIVISADERO |
Street Address 2 Of The Provider |
5TH FLOOR |
City Of The Provider |
SAN FRANCISCO |
Zip Code Of The Provider |
941430001 |
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 |
719 |
Number Of Medicare Beneficiaries |
318 |
Total Submitted Charge Amount |
337866 |
Total Medicare Allowed Amount |
58755.14 |
Total Medicare Payment Amount |
39761.4 |
Total Medicare Standardized Payment Amount |
35046.16 |
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 |
719 |
Number Of Medicare Beneficiaries With Medical Services |
318 |
Total Medical Submitted Charge Amount |
337866 |
Total Medical Medicare Allowed Amount |
58755.14 |
Total Medical Medicare Payment Amount |
39761.4 |
Total Medical Medicare Standardized Payment Amount |
35046.16 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
76 |
Number Of Beneficiaries Age 65 to 74 |
120 |
Number Of Beneficiaries Age 75 to 84 |
83 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
158 |
Number Of Male Beneficiaries |
160 |
Number Of Non Hispanic White Beneficiaries |
161 |
Number Of Black or African American Beneficiaries |
42 |
Number Of AsianPacific Islander Beneficiaries |
77 |
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 |
168 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
150 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4566 |