| National Provider Identifier [NPI]: | 1437298288 |
| Last Name Of The Provider | IKEDA |
| First Name Of The Provider | DEBRA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 875 BLAKE WILBUR DR |
| Street Address 2 Of The Provider | RADIOLOGY 1104 |
| City Of The Provider | PALO ALTO |
| Zip Code Of The Provider | 943042205 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 2515 |
| Number Of Medicare Beneficiaries | 1487 |
| Total Submitted Charge Amount | 338464 |
| Total Medicare Allowed Amount | 56717.86 |
| Total Medicare Payment Amount | 45780.72 |
| Total Medicare Standardized Payment Amount | 40931.51 |
| 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 | 51 |
| Number Of Medical Services | 2515 |
| Number Of Medicare Beneficiaries With Medical Services | 1487 |
| Total Medical Submitted Charge Amount | 338464 |
| Total Medical Medicare Allowed Amount | 56717.86 |
| Total Medical Medicare Payment Amount | 45780.72 |
| Total Medical Medicare Standardized Payment Amount | 40931.51 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 235 |
| Number Of Beneficiaries Age 65 to 74 | 700 |
| Number Of Beneficiaries Age 75 to 84 | 393 |
| Number Of Beneficiaries Age Greater 84 | 159 |
| Number Of Female Beneficiaries | 1093 |
| Number Of Male Beneficiaries | 394 |
| Number Of Non Hispanic White Beneficiaries | 921 |
| Number Of Black or African American Beneficiaries | 75 |
| Number Of AsianPacific Islander Beneficiaries | 273 |
| Number Of Hispanic Beneficiaries | 157 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1102 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 385 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 27 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5972 |