National Provider Identifier [NPI]: |
1093719536 |
Last Name Of The Provider |
HASSASSIAN |
First Name Of The Provider |
SASSAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8644 SUDLEY RD |
Street Address 2 Of The Provider |
STE 117 |
City Of The Provider |
MANASSAS |
Zip Code Of The Provider |
201104417 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Interventional Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
60 |
Number Of Services |
4968 |
Number Of Medicare Beneficiaries |
328 |
Total Submitted Charge Amount |
1678024 |
Total Medicare Allowed Amount |
380773.47 |
Total Medicare Payment Amount |
283321.19 |
Total Medicare Standardized Payment Amount |
269354.44 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
2208 |
Number Of Medicare Beneficiaries With Drug Services |
220 |
Total Drug Submitted ChargeAmount |
107717 |
Total Drug Medicare AllowedAmount |
20988.67 |
Total Drug Medicare PaymentAmount |
15624.95 |
Total Drug Medicare Standardized Payment Amount |
15624.95 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
47 |
Number Of Medical Services |
2760 |
Number Of Medicare Beneficiaries With Medical Services |
328 |
Total Medical Submitted Charge Amount |
1570307 |
Total Medical Medicare Allowed Amount |
359784.8 |
Total Medical Medicare Payment Amount |
267696.24 |
Total Medical Medicare Standardized Payment Amount |
253729.49 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
98 |
Number Of Beneficiaries Age 65 to 74 |
132 |
Number Of Beneficiaries Age 75 to 84 |
70 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
223 |
Number Of Male Beneficiaries |
105 |
Number Of Non Hispanic White Beneficiaries |
254 |
Number Of Black or African American Beneficiaries |
37 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
255 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
73 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1665 |