| National Provider Identifier [NPI]: | 1730159500 |
| Last Name Of The Provider | KASSABIAN |
| First Name Of The Provider | LIBARID |
| 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 | 2 WAKE ROBIN RD |
| Street Address 2 Of The Provider | SUITE 106 |
| City Of The Provider | LINCOLN |
| Zip Code Of The Provider | 028654241 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 259 |
| Number Of Medicare Beneficiaries | 149 |
| Total Submitted Charge Amount | 30113.54 |
| Total Medicare Allowed Amount | 21385.23 |
| Total Medicare Payment Amount | 12832.3 |
| Total Medicare Standardized Payment Amount | 12381.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 25 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 413.54 |
| Total Drug Medicare AllowedAmount | 88.89 |
| Total Drug Medicare PaymentAmount | 67.18 |
| Total Drug Medicare Standardized Payment Amount | 67.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 234 |
| Number Of Medicare Beneficiaries With Medical Services | 148 |
| Total Medical Submitted Charge Amount | 29700 |
| Total Medical Medicare Allowed Amount | 21296.34 |
| Total Medical Medicare Payment Amount | 12765.12 |
| Total Medical Medicare Standardized Payment Amount | 12314.16 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 57 |
| Number Of Beneficiaries Age 75 to 84 | 38 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 98 |
| Number Of Male Beneficiaries | 51 |
| Number Of Non Hispanic White Beneficiaries | 134 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 120 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 29 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0093 |