National Provider Identifier [NPI]: |
1275524589 |
Last Name Of The Provider |
TSUTAOKA |
First Name Of The Provider |
ELSA |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1220 ROSSMOOR PKWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
WALNUT CREEK |
Zip Code Of The Provider |
945952501 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
972 |
Number Of Medicare Beneficiaries |
382 |
Total Submitted Charge Amount |
217987 |
Total Medicare Allowed Amount |
66727.92 |
Total Medicare Payment Amount |
43980.78 |
Total Medicare Standardized Payment Amount |
38081.21 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
89 |
Number Of Medicare Beneficiaries With Drug Services |
44 |
Total Drug Submitted ChargeAmount |
2635 |
Total Drug Medicare AllowedAmount |
316.72 |
Total Drug Medicare PaymentAmount |
277.2 |
Total Drug Medicare Standardized Payment Amount |
277.2 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
883 |
Number Of Medicare Beneficiaries With Medical Services |
382 |
Total Medical Submitted Charge Amount |
215352 |
Total Medical Medicare Allowed Amount |
66411.2 |
Total Medical Medicare Payment Amount |
43703.58 |
Total Medical Medicare Standardized Payment Amount |
37804.01 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
82 |
Number Of Beneficiaries Age 65 to 74 |
163 |
Number Of Beneficiaries Age 75 to 84 |
78 |
Number Of Beneficiaries Age Greater 84 |
59 |
Number Of Female Beneficiaries |
229 |
Number Of Male Beneficiaries |
153 |
Number Of Non Hispanic White Beneficiaries |
237 |
Number Of Black or African American Beneficiaries |
92 |
Number Of AsianPacific Islander Beneficiaries |
26 |
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 |
255 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
127 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.039 |