National Provider Identifier [NPI]: |
1164537643 |
Last Name Of The Provider |
HASSAN |
First Name Of The Provider |
ANISA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3315 MCINTOSH CIR |
Street Address 2 Of The Provider |
|
City Of The Provider |
JOPLIN |
Zip Code Of The Provider |
648043649 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
878 |
Number Of Medicare Beneficiaries |
276 |
Total Submitted Charge Amount |
98022.25 |
Total Medicare Allowed Amount |
65466.9 |
Total Medicare Payment Amount |
47823.77 |
Total Medicare Standardized Payment Amount |
51268.37 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
11 |
Number Of Medical Services |
878 |
Number Of Medicare Beneficiaries With Medical Services |
276 |
Total Medical Submitted Charge Amount |
98022.25 |
Total Medical Medicare Allowed Amount |
65466.9 |
Total Medical Medicare Payment Amount |
47823.77 |
Total Medical Medicare Standardized Payment Amount |
51268.37 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
112 |
Number Of Beneficiaries Age 75 to 84 |
100 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
210 |
Number Of Male Beneficiaries |
66 |
Number Of Non Hispanic White Beneficiaries |
265 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
248 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
64 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.7432 |