| National Provider Identifier [NPI]: | 1043482706 |
| Last Name Of The Provider | OSTROUKHOVA |
| First Name Of The Provider | MARINA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1329 LUSITANA ST STE 603 |
| Street Address 2 Of The Provider | |
| City Of The Provider | HONOLULU |
| Zip Code Of The Provider | 968132431 |
| 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 | 24 |
| Number Of Services | 340 |
| Number Of Medicare Beneficiaries | 35 |
| Total Submitted Charge Amount | 19913.4 |
| Total Medicare Allowed Amount | 11872.65 |
| Total Medicare Payment Amount | 8586.58 |
| Total Medicare Standardized Payment Amount | 8499.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 21 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 380.59 |
| Total Drug Medicare AllowedAmount | 71.92 |
| Total Drug Medicare PaymentAmount | 65.72 |
| Total Drug Medicare Standardized Payment Amount | 65.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 319 |
| Number Of Medicare Beneficiaries With Medical Services | 35 |
| Total Medical Submitted Charge Amount | 19532.81 |
| Total Medical Medicare Allowed Amount | 11800.73 |
| Total Medical Medicare Payment Amount | 8520.86 |
| Total Medical Medicare Standardized Payment Amount | 8433.91 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 18 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | 16 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 0 |
| Percent Of With Asthma | 49 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8328 |