| National Provider Identifier [NPI]: | 1073591038 |
| Last Name Of The Provider | HASS |
| First Name Of The Provider | FREDERICK |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 750 LAS GALLINAS AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN RAFAEL |
| Zip Code Of The Provider | 94903 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 1922 |
| Number Of Medicare Beneficiaries | 306 |
| Total Submitted Charge Amount | 285058 |
| Total Medicare Allowed Amount | 206200.97 |
| Total Medicare Payment Amount | 154595.87 |
| Total Medicare Standardized Payment Amount | 138876.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 50 |
| Number Of Medicare Beneficiaries With Drug Services | 45 |
| Total Drug Submitted ChargeAmount | 1755 |
| Total Drug Medicare AllowedAmount | 1172.72 |
| Total Drug Medicare PaymentAmount | 1148.97 |
| Total Drug Medicare Standardized Payment Amount | 1148.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 1872 |
| Number Of Medicare Beneficiaries With Medical Services | 306 |
| Total Medical Submitted Charge Amount | 283303 |
| Total Medical Medicare Allowed Amount | 205028.25 |
| Total Medical Medicare Payment Amount | 153446.9 |
| Total Medical Medicare Standardized Payment Amount | 137727.04 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | 104 |
| Number Of Beneficiaries Age Greater 84 | 113 |
| Number Of Female Beneficiaries | 174 |
| Number Of Male Beneficiaries | 132 |
| Number Of Non Hispanic White Beneficiaries | 284 |
| 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 | 288 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.2678 |