| National Provider Identifier [NPI]: | 1508808635 |
| Last Name Of The Provider | BOUHASIN |
| First Name Of The Provider | ANDRE |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 170 INDUSTRAIL DRIVE |
| Street Address 2 Of The Provider | SUITE 103 |
| City Of The Provider | FESTUS |
| Zip Code Of The Provider | 63028 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 113 |
| Number Of Services | 11519 |
| Number Of Medicare Beneficiaries | 847 |
| Total Submitted Charge Amount | 3722284 |
| Total Medicare Allowed Amount | 1432171.24 |
| Total Medicare Payment Amount | 1078779.73 |
| Total Medicare Standardized Payment Amount | 1176682.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 4886 |
| Number Of Medicare Beneficiaries With Drug Services | 39 |
| Total Drug Submitted ChargeAmount | 4886 |
| Total Drug Medicare AllowedAmount | 882.46 |
| Total Drug Medicare PaymentAmount | 657.44 |
| Total Drug Medicare Standardized Payment Amount | 657.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 112 |
| Number Of Medical Services | 6633 |
| Number Of Medicare Beneficiaries With Medical Services | 847 |
| Total Medical Submitted Charge Amount | 3717398 |
| Total Medical Medicare Allowed Amount | 1431288.78 |
| Total Medical Medicare Payment Amount | 1078122.29 |
| Total Medical Medicare Standardized Payment Amount | 1176024.91 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 219 |
| Number Of Beneficiaries Age 65 to 74 | 324 |
| Number Of Beneficiaries Age 75 to 84 | 220 |
| Number Of Beneficiaries Age Greater 84 | 84 |
| Number Of Female Beneficiaries | 436 |
| Number Of Male Beneficiaries | 411 |
| Number Of Non Hispanic White Beneficiaries | 827 |
| Number Of Black or African American Beneficiaries | |
| 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 | 585 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 262 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 51 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8194 |