National Provider Identifier [NPI]: |
1003904632 |
Last Name Of The Provider |
VIERRA |
First Name Of The Provider |
JOSEPH |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
888 S KING ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
HONOLULU |
Zip Code Of The Provider |
968133009 |
State Code Of The Provider |
HI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
606 |
Number Of Medicare Beneficiaries |
225 |
Total Submitted Charge Amount |
137872 |
Total Medicare Allowed Amount |
55838.77 |
Total Medicare Payment Amount |
41714.4 |
Total Medicare Standardized Payment Amount |
41630.15 |
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 |
14 |
Number Of Medical Services |
606 |
Number Of Medicare Beneficiaries With Medical Services |
225 |
Total Medical Submitted Charge Amount |
137872 |
Total Medical Medicare Allowed Amount |
55838.77 |
Total Medical Medicare Payment Amount |
41714.4 |
Total Medical Medicare Standardized Payment Amount |
41630.15 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
61 |
Number Of Beneficiaries Age 75 to 84 |
65 |
Number Of Beneficiaries Age Greater 84 |
73 |
Number Of Female Beneficiaries |
128 |
Number Of Male Beneficiaries |
97 |
Number Of Non Hispanic White Beneficiaries |
78 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
110 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
23 |
Number Of Beneficiaries With Medicare Only Entitlement |
184 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
41 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
22 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
21 |
Average HCC Risk Score Of Beneficiaries |
2.1825 |