| National Provider Identifier [NPI]: | 1831397603 |
| Last Name Of The Provider | TASSONE |
| First Name Of The Provider | HEATHER |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11234 ANDERSON ST |
| Street Address 2 Of The Provider | MC-A108 |
| City Of The Provider | LOMA LINDA |
| Zip Code Of The Provider | 923542804 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 535 |
| Number Of Medicare Beneficiaries | 419 |
| Total Submitted Charge Amount | 244813 |
| Total Medicare Allowed Amount | 75590.58 |
| Total Medicare Payment Amount | 58679.96 |
| Total Medicare Standardized Payment Amount | 57875.59 |
| 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 | 33 |
| Number Of Medical Services | 535 |
| Number Of Medicare Beneficiaries With Medical Services | 419 |
| Total Medical Submitted Charge Amount | 244813 |
| Total Medical Medicare Allowed Amount | 75590.58 |
| Total Medical Medicare Payment Amount | 58679.96 |
| Total Medical Medicare Standardized Payment Amount | 57875.59 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 135 |
| Number Of Beneficiaries Age 65 to 74 | 127 |
| Number Of Beneficiaries Age 75 to 84 | 91 |
| Number Of Beneficiaries Age Greater 84 | 66 |
| Number Of Female Beneficiaries | 242 |
| Number Of Male Beneficiaries | 177 |
| Number Of Non Hispanic White Beneficiaries | 202 |
| Number Of Black or African American Beneficiaries | 61 |
| Number Of AsianPacific Islander Beneficiaries | 24 |
| Number Of Hispanic Beneficiaries | 116 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 164 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 255 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.715 |