National Provider Identifier [NPI]: |
1194761486 |
Last Name Of The Provider |
KASSINOVE |
First Name Of The Provider |
ANDREW |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2131 W 3RD ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
LOS ANGELES |
Zip Code Of The Provider |
900571901 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
524 |
Number Of Medicare Beneficiaries |
336 |
Total Submitted Charge Amount |
239813 |
Total Medicare Allowed Amount |
56099.78 |
Total Medicare Payment Amount |
43478.22 |
Total Medicare Standardized Payment Amount |
42978.55 |
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 |
23 |
Number Of Medical Services |
524 |
Number Of Medicare Beneficiaries With Medical Services |
336 |
Total Medical Submitted Charge Amount |
239813 |
Total Medical Medicare Allowed Amount |
56099.78 |
Total Medical Medicare Payment Amount |
43478.22 |
Total Medical Medicare Standardized Payment Amount |
42978.55 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
91 |
Number Of Beneficiaries Age 65 to 74 |
120 |
Number Of Beneficiaries Age 75 to 84 |
69 |
Number Of Beneficiaries Age Greater 84 |
56 |
Number Of Female Beneficiaries |
169 |
Number Of Male Beneficiaries |
167 |
Number Of Non Hispanic White Beneficiaries |
173 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
138 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
135 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
201 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.3932 |