| National Provider Identifier [NPI]: | 1023053808 |
| Last Name Of The Provider | KASSEM |
| First Name Of The Provider | MOHAMMED |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1901 W HARRISON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606123714 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 16 |
| Number Of Services | 1007 |
| Number Of Medicare Beneficiaries | 286 |
| Total Submitted Charge Amount | 213285 |
| Total Medicare Allowed Amount | 115344.36 |
| Total Medicare Payment Amount | 86701.21 |
| Total Medicare Standardized Payment Amount | 80878.5 |
| 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 | 16 |
| Number Of Medical Services | 1007 |
| Number Of Medicare Beneficiaries With Medical Services | 286 |
| Total Medical Submitted Charge Amount | 213285 |
| Total Medical Medicare Allowed Amount | 115344.36 |
| Total Medical Medicare Payment Amount | 86701.21 |
| Total Medical Medicare Standardized Payment Amount | 80878.5 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 67 |
| Number Of Beneficiaries Age 65 to 74 | 118 |
| Number Of Beneficiaries Age 75 to 84 | 78 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 149 |
| Number Of Male Beneficiaries | 137 |
| Number Of Non Hispanic White Beneficiaries | 29 |
| Number Of Black or African American Beneficiaries | 203 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 54 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 78 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 208 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 22 |
| Percent Of With Cancer | 42 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 56 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 59 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 62 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.6052 |