| National Provider Identifier [NPI]: | 1114222676 |
| Last Name Of The Provider | KASSA |
| First Name Of The Provider | YILIKAL |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1612 MILSTEAD RD NE |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | CONYERS |
| Zip Code Of The Provider | 300123738 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 2433 |
| Number Of Medicare Beneficiaries | 646 |
| Total Submitted Charge Amount | 692047 |
| Total Medicare Allowed Amount | 397941.31 |
| Total Medicare Payment Amount | 309135.74 |
| Total Medicare Standardized Payment Amount | 305394.87 |
| 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 | 26 |
| Number Of Medical Services | 2433 |
| Number Of Medicare Beneficiaries With Medical Services | 646 |
| Total Medical Submitted Charge Amount | 692047 |
| Total Medical Medicare Allowed Amount | 397941.31 |
| Total Medical Medicare Payment Amount | 309135.74 |
| Total Medical Medicare Standardized Payment Amount | 305394.87 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 270 |
| Number Of Beneficiaries Age 65 to 74 | 161 |
| Number Of Beneficiaries Age 75 to 84 | 145 |
| Number Of Beneficiaries Age Greater 84 | 70 |
| Number Of Female Beneficiaries | 326 |
| Number Of Male Beneficiaries | 320 |
| Number Of Non Hispanic White Beneficiaries | 214 |
| Number Of Black or African American Beneficiaries | 410 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 344 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 302 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 51 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 66 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 5.0013 |