National Provider Identifier [NPI]: |
1487742128 |
Last Name Of The Provider |
TERAMOTO |
First Name Of The Provider |
RAE |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
321 N KUAKINI ST |
Street Address 2 Of The Provider |
SUITE #201 |
City Of The Provider |
HONOLULU |
Zip Code Of The Provider |
968172364 |
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 |
2132 |
Number Of Medicare Beneficiaries |
458 |
Total Submitted Charge Amount |
175909.03 |
Total Medicare Allowed Amount |
139392.31 |
Total Medicare Payment Amount |
97938.21 |
Total Medicare Standardized Payment Amount |
94368.13 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
323 |
Number Of Medicare Beneficiaries With Drug Services |
246 |
Total Drug Submitted ChargeAmount |
16156.12 |
Total Drug Medicare AllowedAmount |
14516.94 |
Total Drug Medicare PaymentAmount |
13582.1 |
Total Drug Medicare Standardized Payment Amount |
13582.1 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
16 |
Number Of Medical Services |
1809 |
Number Of Medicare Beneficiaries With Medical Services |
458 |
Total Medical Submitted Charge Amount |
159752.91 |
Total Medical Medicare Allowed Amount |
124875.37 |
Total Medical Medicare Payment Amount |
84356.11 |
Total Medical Medicare Standardized Payment Amount |
80786.03 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
208 |
Number Of Beneficiaries Age 75 to 84 |
146 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
312 |
Number Of Male Beneficiaries |
146 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
374 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
65 |
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
4 |
Percent Of With Depression |
4 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
22 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1065 |