| National Provider Identifier [NPI]: | 1316906142 |
| Last Name Of The Provider | HASSAN |
| First Name Of The Provider | ALI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 23455 MICHIGAN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | DEARBORN |
| Zip Code Of The Provider | 481241908 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 75 |
| Number Of Services | 773 |
| Number Of Medicare Beneficiaries | 334 |
| Total Submitted Charge Amount | 220686 |
| Total Medicare Allowed Amount | 59533.26 |
| Total Medicare Payment Amount | 44530.52 |
| Total Medicare Standardized Payment Amount | 42793.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 154 |
| Number Of Medicare Beneficiaries With Drug Services | 28 |
| Total Drug Submitted ChargeAmount | 862 |
| Total Drug Medicare AllowedAmount | 65.2 |
| Total Drug Medicare PaymentAmount | 53.52 |
| Total Drug Medicare Standardized Payment Amount | 53.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 65 |
| Number Of Medical Services | 619 |
| Number Of Medicare Beneficiaries With Medical Services | 334 |
| Total Medical Submitted Charge Amount | 219824 |
| Total Medical Medicare Allowed Amount | 59468.06 |
| Total Medical Medicare Payment Amount | 44477 |
| Total Medical Medicare Standardized Payment Amount | 42740.14 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 144 |
| Number Of Beneficiaries Age 65 to 74 | 89 |
| Number Of Beneficiaries Age 75 to 84 | 49 |
| Number Of Beneficiaries Age Greater 84 | 52 |
| Number Of Female Beneficiaries | 204 |
| Number Of Male Beneficiaries | 130 |
| Number Of Non Hispanic White Beneficiaries | 114 |
| Number Of Black or African American Beneficiaries | 204 |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 156 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 178 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 23 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.4584 |