| National Provider Identifier [NPI]: | 1962408088 |
| Last Name Of The Provider | CASSIS |
| First Name Of The Provider | TAMELLA |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9301 DAYFLOWER ST |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | PROSPECT |
| Zip Code Of The Provider | 400597585 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 2204 |
| Number Of Medicare Beneficiaries | 523 |
| Total Submitted Charge Amount | 160564 |
| Total Medicare Allowed Amount | 114228.37 |
| Total Medicare Payment Amount | 80354.59 |
| Total Medicare Standardized Payment Amount | 86559.9 |
| Drug Suppress Indicator | * |
| Number Of HCPCS Associated With Drug Services | |
| Number Of Drug Services | |
| Number Of Medicare Beneficiaries With Drug Services | |
| Total Drug Submitted ChargeAmount | |
| Total Drug Medicare AllowedAmount | |
| Total Drug Medicare PaymentAmount | |
| Total Drug Medicare Standardized Payment Amount | |
| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
| Number Of Medical Services | |
| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
| Total Medical Medicare Payment Amount | |
| Total Medical Medicare Standardized Payment Amount | |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 360 |
| Number Of Beneficiaries Age 75 to 84 | 108 |
| Number Of Beneficiaries Age Greater 84 | 41 |
| Number Of Female Beneficiaries | 338 |
| Number Of Male Beneficiaries | 185 |
| Number Of Non Hispanic White Beneficiaries | 501 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 5 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.7802 |