National Provider Identifier [NPI]: |
1396954376 |
Last Name Of The Provider |
YASSA |
First Name Of The Provider |
EANAS |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4069 LAKE DR SE |
Street Address 2 Of The Provider |
SUITE 312 |
City Of The Provider |
GRAND RAPIDS |
Zip Code Of The Provider |
495468816 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Vascular Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
137 |
Number Of Services |
1116 |
Number Of Medicare Beneficiaries |
410 |
Total Submitted Charge Amount |
474886 |
Total Medicare Allowed Amount |
189427.06 |
Total Medicare Payment Amount |
145847.96 |
Total Medicare Standardized Payment Amount |
150582.26 |
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 |
137 |
Number Of Medical Services |
1116 |
Number Of Medicare Beneficiaries With Medical Services |
410 |
Total Medical Submitted Charge Amount |
474886 |
Total Medical Medicare Allowed Amount |
189427.06 |
Total Medical Medicare Payment Amount |
145847.96 |
Total Medical Medicare Standardized Payment Amount |
150582.26 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
88 |
Number Of Beneficiaries Age 65 to 74 |
127 |
Number Of Beneficiaries Age 75 to 84 |
140 |
Number Of Beneficiaries Age Greater 84 |
55 |
Number Of Female Beneficiaries |
197 |
Number Of Male Beneficiaries |
213 |
Number Of Non Hispanic White Beneficiaries |
336 |
Number Of Black or African American Beneficiaries |
46 |
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 |
283 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
127 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
67 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.8513 |