National Provider Identifier [NPI]: |
1053410555 |
Last Name Of The Provider |
SAMESHIMA |
First Name Of The Provider |
STEVEN |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1329 LUSITANA ST |
Street Address 2 Of The Provider |
SUITE 306 |
City Of The Provider |
HONOLULU |
Zip Code Of The Provider |
968132429 |
State Code Of The Provider |
HI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
1338 |
Number Of Medicare Beneficiaries |
393 |
Total Submitted Charge Amount |
286153.53 |
Total Medicare Allowed Amount |
171989.25 |
Total Medicare Payment Amount |
120935.69 |
Total Medicare Standardized Payment Amount |
115231.23 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
137 |
Number Of Beneficiaries Age 75 to 84 |
139 |
Number Of Beneficiaries Age Greater 84 |
106 |
Number Of Female Beneficiaries |
248 |
Number Of Male Beneficiaries |
145 |
Number Of Non Hispanic White Beneficiaries |
102 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
246 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
32 |
Number Of Beneficiaries With Medicare Only Entitlement |
382 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
11 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
9 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0919 |