| National Provider Identifier [NPI]: | 1992768410 |
| Last Name Of The Provider | YASREBI |
| First Name Of The Provider | HOSEIN |
| 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 | 3599 UNIVERSITY BLVD S |
| Street Address 2 Of The Provider | STE 506 |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322164252 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 11 |
| Number Of Services | 176 |
| Number Of Medicare Beneficiaries | 22 |
| Total Submitted Charge Amount | 17036 |
| Total Medicare Allowed Amount | 14057.84 |
| Total Medicare Payment Amount | 10676.79 |
| Total Medicare Standardized Payment Amount | 10513.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 64 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 301 |
| Total Drug Medicare AllowedAmount | 134.46 |
| Total Drug Medicare PaymentAmount | 103.72 |
| Total Drug Medicare Standardized Payment Amount | 103.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 8 |
| Number Of Medical Services | 112 |
| Number Of Medicare Beneficiaries With Medical Services | 22 |
| Total Medical Submitted Charge Amount | 16735 |
| Total Medical Medicare Allowed Amount | 13923.38 |
| Total Medical Medicare Payment Amount | 10573.07 |
| Total Medical Medicare Standardized Payment Amount | 10409.67 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Percent Of With Alzheimers Disease or Dementia | 0 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 0 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.251 |