National Provider Identifier [NPI]: |
1720099682 |
Last Name Of The Provider |
TAKATA |
First Name Of The Provider |
ROBIN |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
321 N KUAKINI ST |
Street Address 2 Of The Provider |
SUITE 306 |
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 |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
63 |
Number Of Services |
321 |
Number Of Medicare Beneficiaries |
217 |
Total Submitted Charge Amount |
300437.26 |
Total Medicare Allowed Amount |
59628.38 |
Total Medicare Payment Amount |
43496.69 |
Total Medicare Standardized Payment Amount |
47174.63 |
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 |
63 |
Number Of Medical Services |
321 |
Number Of Medicare Beneficiaries With Medical Services |
217 |
Total Medical Submitted Charge Amount |
300437.26 |
Total Medical Medicare Allowed Amount |
59628.38 |
Total Medical Medicare Payment Amount |
43496.69 |
Total Medical Medicare Standardized Payment Amount |
47174.63 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
94 |
Number Of Beneficiaries Age 75 to 84 |
77 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
114 |
Number Of Male Beneficiaries |
103 |
Number Of Non Hispanic White Beneficiaries |
41 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
139 |
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 |
201 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
16 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6023 |