| National Provider Identifier [NPI]: | 1437112091 |
| Last Name Of The Provider | HASSUMANI |
| First Name Of The Provider | JANICE |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6341 UNIVERSITY AVE NE |
| Street Address 2 Of The Provider | |
| City Of The Provider | FRIDLEY |
| Zip Code Of The Provider | 554324946 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 90 |
| Number Of Services | 2093 |
| Number Of Medicare Beneficiaries | 239 |
| Total Submitted Charge Amount | 136737.7 |
| Total Medicare Allowed Amount | 58770.4 |
| Total Medicare Payment Amount | 44115.54 |
| Total Medicare Standardized Payment Amount | 45404.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 886 |
| Number Of Medicare Beneficiaries With Drug Services | 66 |
| Total Drug Submitted ChargeAmount | 6325.7 |
| Total Drug Medicare AllowedAmount | 4590.11 |
| Total Drug Medicare PaymentAmount | 4435.37 |
| Total Drug Medicare Standardized Payment Amount | 4435.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 80 |
| Number Of Medical Services | 1207 |
| Number Of Medicare Beneficiaries With Medical Services | 239 |
| Total Medical Submitted Charge Amount | 130412 |
| Total Medical Medicare Allowed Amount | 54180.29 |
| Total Medical Medicare Payment Amount | 39680.17 |
| Total Medical Medicare Standardized Payment Amount | 40968.78 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 80 |
| Number Of Beneficiaries Age 65 to 74 | 74 |
| Number Of Beneficiaries Age 75 to 84 | 60 |
| Number Of Beneficiaries Age Greater 84 | 25 |
| Number Of Female Beneficiaries | 185 |
| Number Of Male Beneficiaries | 54 |
| Number Of Non Hispanic White Beneficiaries | 219 |
| 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 | 167 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 72 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 29 |
| Percent Of With Hypertension | 45 |
| Percent Of With Ischemic Heart Disease | 14 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 19 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.149 |