National Provider Identifier [NPI]: |
1235305327 |
Last Name Of The Provider |
KANESHIRO |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
# L25 |
Street Address 2 Of The Provider |
9500 EUCLID AVE |
City Of The Provider |
CLEVELAND |
Zip Code Of The Provider |
441950001 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
1640 |
Number Of Medicare Beneficiaries |
444 |
Total Submitted Charge Amount |
194668.04 |
Total Medicare Allowed Amount |
62174.93 |
Total Medicare Payment Amount |
47711.6 |
Total Medicare Standardized Payment Amount |
37264.36 |
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 |
34 |
Number Of Medical Services |
1640 |
Number Of Medicare Beneficiaries With Medical Services |
444 |
Total Medical Submitted Charge Amount |
194668.04 |
Total Medical Medicare Allowed Amount |
62174.93 |
Total Medical Medicare Payment Amount |
47711.6 |
Total Medical Medicare Standardized Payment Amount |
37264.36 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
68 |
Number Of Beneficiaries Age 65 to 74 |
183 |
Number Of Beneficiaries Age 75 to 84 |
133 |
Number Of Beneficiaries Age Greater 84 |
60 |
Number Of Female Beneficiaries |
241 |
Number Of Male Beneficiaries |
203 |
Number Of Non Hispanic White Beneficiaries |
378 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
39 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
350 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
94 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
23 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.668 |