National Provider Identifier [NPI]: |
1174682983 |
Last Name Of The Provider |
YASSA |
First Name Of The Provider |
EMAD |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PT |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2855 INTERNATIONAL CIR |
Street Address 2 Of The Provider |
|
City Of The Provider |
COLORADO SPRINGS |
Zip Code Of The Provider |
809103144 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Therapist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
18937 |
Number Of Medicare Beneficiaries |
284 |
Total Submitted Charge Amount |
1230368 |
Total Medicare Allowed Amount |
520965.41 |
Total Medicare Payment Amount |
402636.41 |
Total Medicare Standardized Payment Amount |
332311.71 |
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 |
13 |
Number Of Medical Services |
18937 |
Number Of Medicare Beneficiaries With Medical Services |
284 |
Total Medical Submitted Charge Amount |
1230368 |
Total Medical Medicare Allowed Amount |
520965.41 |
Total Medical Medicare Payment Amount |
402636.41 |
Total Medical Medicare Standardized Payment Amount |
332311.71 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
70 |
Number Of Beneficiaries Age 65 to 74 |
94 |
Number Of Beneficiaries Age 75 to 84 |
82 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
189 |
Number Of Male Beneficiaries |
95 |
Number Of Non Hispanic White Beneficiaries |
208 |
Number Of Black or African American Beneficiaries |
27 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
32 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
195 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
89 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1827 |