National Provider Identifier [NPI]: |
1881629095 |
Last Name Of The Provider |
MORISHIMA |
First Name Of The Provider |
AMY |
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 |
2734 EL CAMINO REAL |
Street Address 2 Of The Provider |
|
City Of The Provider |
SANTA CLARA |
Zip Code Of The Provider |
950513007 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
507 |
Number Of Medicare Beneficiaries |
96 |
Total Submitted Charge Amount |
59154 |
Total Medicare Allowed Amount |
26223.07 |
Total Medicare Payment Amount |
18421.51 |
Total Medicare Standardized Payment Amount |
15350.12 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
202 |
Number Of Medicare Beneficiaries With Drug Services |
27 |
Total Drug Submitted ChargeAmount |
2656 |
Total Drug Medicare AllowedAmount |
1580.24 |
Total Drug Medicare PaymentAmount |
1437.5 |
Total Drug Medicare Standardized Payment Amount |
1437.5 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
305 |
Number Of Medicare Beneficiaries With Medical Services |
96 |
Total Medical Submitted Charge Amount |
56498 |
Total Medical Medicare Allowed Amount |
24642.83 |
Total Medical Medicare Payment Amount |
16984.01 |
Total Medical Medicare Standardized Payment Amount |
13912.62 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
37 |
Number Of Beneficiaries Age 75 to 84 |
25 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
83 |
Number Of Male Beneficiaries |
13 |
Number Of Non Hispanic White Beneficiaries |
59 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
22 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
71 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
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 |
20 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
51 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9875 |