National Provider Identifier [NPI]: |
1285759787 |
Last Name Of The Provider |
YOSHIDA |
First Name Of The Provider |
SHELENE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1011 BALDWIN PARK BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
BALDWIN PARK |
Zip Code Of The Provider |
917065806 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
74 |
Number Of Services |
1421 |
Number Of Medicare Beneficiaries |
121 |
Total Submitted Charge Amount |
226566.96 |
Total Medicare Allowed Amount |
41624.42 |
Total Medicare Payment Amount |
31837.37 |
Total Medicare Standardized Payment Amount |
33482.24 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
1086 |
Number Of Medicare Beneficiaries With Drug Services |
37 |
Total Drug Submitted ChargeAmount |
54186.5 |
Total Drug Medicare AllowedAmount |
19506.51 |
Total Drug Medicare PaymentAmount |
15060.43 |
Total Drug Medicare Standardized Payment Amount |
15060.43 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
68 |
Number Of Medical Services |
335 |
Number Of Medicare Beneficiaries With Medical Services |
121 |
Total Medical Submitted Charge Amount |
172380.46 |
Total Medical Medicare Allowed Amount |
22117.91 |
Total Medical Medicare Payment Amount |
16776.94 |
Total Medical Medicare Standardized Payment Amount |
18421.81 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
45 |
Number Of Beneficiaries Age 75 to 84 |
35 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
73 |
Number Of Male Beneficiaries |
48 |
Number Of Non Hispanic White Beneficiaries |
107 |
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 |
96 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
12 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2588 |