National Provider Identifier [NPI]: |
1619968179 |
Last Name Of The Provider |
SASSOWER |
First Name Of The Provider |
KENNETH |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
15 PARKMAN ST |
Street Address 2 Of The Provider |
WAC 835 |
City Of The Provider |
BOSTON |
Zip Code Of The Provider |
021143117 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
643 |
Number Of Medicare Beneficiaries |
472 |
Total Submitted Charge Amount |
239609 |
Total Medicare Allowed Amount |
66319.97 |
Total Medicare Payment Amount |
48437.96 |
Total Medicare Standardized Payment Amount |
46330.06 |
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 |
12 |
Number Of Medical Services |
643 |
Number Of Medicare Beneficiaries With Medical Services |
472 |
Total Medical Submitted Charge Amount |
239609 |
Total Medical Medicare Allowed Amount |
66319.97 |
Total Medical Medicare Payment Amount |
48437.96 |
Total Medical Medicare Standardized Payment Amount |
46330.06 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
149 |
Number Of Beneficiaries Age 65 to 74 |
188 |
Number Of Beneficiaries Age 75 to 84 |
101 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
220 |
Number Of Male Beneficiaries |
252 |
Number Of Non Hispanic White Beneficiaries |
411 |
Number Of Black or African American Beneficiaries |
24 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
300 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
172 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
23 |
Average HCC Risk Score Of Beneficiaries |
1.5051 |