National Provider Identifier [NPI]: |
1386818342 |
Last Name Of The Provider |
KASSAB |
First Name Of The Provider |
DURIED |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12250 E ILIFF AVE |
Street Address 2 Of The Provider |
#300 |
City Of The Provider |
AURORA |
Zip Code Of The Provider |
800146318 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
1347 |
Number Of Medicare Beneficiaries |
543 |
Total Submitted Charge Amount |
286807 |
Total Medicare Allowed Amount |
145683.24 |
Total Medicare Payment Amount |
113549.82 |
Total Medicare Standardized Payment Amount |
113580.45 |
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 |
21 |
Number Of Medical Services |
1347 |
Number Of Medicare Beneficiaries With Medical Services |
543 |
Total Medical Submitted Charge Amount |
286807 |
Total Medical Medicare Allowed Amount |
145683.24 |
Total Medical Medicare Payment Amount |
113549.82 |
Total Medical Medicare Standardized Payment Amount |
113580.45 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
121 |
Number Of Beneficiaries Age 65 to 74 |
113 |
Number Of Beneficiaries Age 75 to 84 |
141 |
Number Of Beneficiaries Age Greater 84 |
168 |
Number Of Female Beneficiaries |
302 |
Number Of Male Beneficiaries |
241 |
Number Of Non Hispanic White Beneficiaries |
474 |
Number Of Black or African American Beneficiaries |
14 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
33 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
403 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
140 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
36 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.2665 |