| National Provider Identifier [NPI]: | 1285601310 |
| Last Name Of The Provider | KURUMA |
| First Name Of The Provider | PAVANI |
| 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 | 3000 COLBY ST |
| Street Address 2 Of The Provider | SUITE 304 |
| City Of The Provider | BERKELEY |
| Zip Code Of The Provider | 947052083 |
| 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 | 26 |
| Number Of Services | 764 |
| Number Of Medicare Beneficiaries | 244 |
| Total Submitted Charge Amount | 93914.11 |
| Total Medicare Allowed Amount | 54483.78 |
| Total Medicare Payment Amount | 40949.73 |
| Total Medicare Standardized Payment Amount | 36978.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 84 |
| Number Of Medicare Beneficiaries With Drug Services | 39 |
| Total Drug Submitted ChargeAmount | 1661 |
| Total Drug Medicare AllowedAmount | 605.77 |
| Total Drug Medicare PaymentAmount | 586.7 |
| Total Drug Medicare Standardized Payment Amount | 586.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 680 |
| Number Of Medicare Beneficiaries With Medical Services | 244 |
| Total Medical Submitted Charge Amount | 92253.11 |
| Total Medical Medicare Allowed Amount | 53878.01 |
| Total Medical Medicare Payment Amount | 40363.03 |
| Total Medical Medicare Standardized Payment Amount | 36392.06 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 127 |
| Number Of Beneficiaries Age 75 to 84 | 58 |
| Number Of Beneficiaries Age Greater 84 | 35 |
| Number Of Female Beneficiaries | 164 |
| Number Of Male Beneficiaries | 80 |
| Number Of Non Hispanic White Beneficiaries | 185 |
| Number Of Black or African American Beneficiaries | 27 |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| 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 | 215 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 29 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 13 |
| Percent Of With Hyperlipidemia | 29 |
| Percent Of With Hypertension | 35 |
| Percent Of With Ischemic Heart Disease | 12 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.853 |