| National Provider Identifier [NPI]: | 1073586772 |
| Last Name Of The Provider | KOSUT |
| First Name Of The Provider | SHEPHARD |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 227 KAHAKO ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | KAILUA |
| Zip Code Of The Provider | 967345905 |
| State Code Of The Provider | HI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 116 |
| Number Of Services | 15655 |
| Number Of Medicare Beneficiaries | 1952 |
| Total Submitted Charge Amount | 901651.77 |
| Total Medicare Allowed Amount | 280025.04 |
| Total Medicare Payment Amount | 206096.27 |
| Total Medicare Standardized Payment Amount | 193574.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 12726 |
| Number Of Medicare Beneficiaries With Drug Services | 123 |
| Total Drug Submitted ChargeAmount | 8578.65 |
| Total Drug Medicare AllowedAmount | 2973.12 |
| Total Drug Medicare PaymentAmount | 2227.41 |
| Total Drug Medicare Standardized Payment Amount | 2227.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 113 |
| Number Of Medical Services | 2929 |
| Number Of Medicare Beneficiaries With Medical Services | 1952 |
| Total Medical Submitted Charge Amount | 893073.12 |
| Total Medical Medicare Allowed Amount | 277051.92 |
| Total Medical Medicare Payment Amount | 203868.86 |
| Total Medical Medicare Standardized Payment Amount | 191346.8 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 161 |
| Number Of Beneficiaries Age 65 to 74 | 788 |
| Number Of Beneficiaries Age 75 to 84 | 669 |
| Number Of Beneficiaries Age Greater 84 | 334 |
| Number Of Female Beneficiaries | 1206 |
| Number Of Male Beneficiaries | 746 |
| Number Of Non Hispanic White Beneficiaries | 279 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 1335 |
| Number Of Hispanic Beneficiaries | 75 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 249 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1640 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 312 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 20 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0537 |