| National Provider Identifier [NPI]: | 1437362498 |
| Last Name Of The Provider | ISHIOKA |
| First Name Of The Provider | KEVIN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 WEST ARBOR DRIVE |
| Street Address 2 Of The Provider | MC 8756 |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 921038756 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 173 |
| Number Of Services | 3447 |
| Number Of Medicare Beneficiaries | 2224 |
| Total Submitted Charge Amount | 365129.5 |
| Total Medicare Allowed Amount | 127388.68 |
| Total Medicare Payment Amount | 93843.85 |
| Total Medicare Standardized Payment Amount | 93495.6 |
| 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 | 173 |
| Number Of Medical Services | 3447 |
| Number Of Medicare Beneficiaries With Medical Services | 2224 |
| Total Medical Submitted Charge Amount | 365129.5 |
| Total Medical Medicare Allowed Amount | 127388.68 |
| Total Medical Medicare Payment Amount | 93843.85 |
| Total Medical Medicare Standardized Payment Amount | 93495.6 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 236 |
| Number Of Beneficiaries Age 65 to 74 | 806 |
| Number Of Beneficiaries Age 75 to 84 | 675 |
| Number Of Beneficiaries Age Greater 84 | 507 |
| Number Of Female Beneficiaries | 1436 |
| Number Of Male Beneficiaries | 788 |
| Number Of Non Hispanic White Beneficiaries | 1407 |
| Number Of Black or African American Beneficiaries | 64 |
| Number Of AsianPacific Islander Beneficiaries | 151 |
| Number Of Hispanic Beneficiaries | 550 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1521 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 703 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.7938 |