National Provider Identifier [NPI]: |
1730284878 |
Last Name Of The Provider |
NISHIMURA |
First Name Of The Provider |
KAREN |
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 |
3 MEDICAL PLAZA DR |
Street Address 2 Of The Provider |
#230 |
City Of The Provider |
ROSEVILLE |
Zip Code Of The Provider |
956613087 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
53 |
Number Of Services |
1988 |
Number Of Medicare Beneficiaries |
428 |
Total Submitted Charge Amount |
485464 |
Total Medicare Allowed Amount |
141725.54 |
Total Medicare Payment Amount |
100890.15 |
Total Medicare Standardized Payment Amount |
95329.83 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
176 |
Number Of Beneficiaries Age 75 to 84 |
186 |
Number Of Beneficiaries Age Greater 84 |
48 |
Number Of Female Beneficiaries |
231 |
Number Of Male Beneficiaries |
197 |
Number Of Non Hispanic White Beneficiaries |
407 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
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 |
413 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9989 |