| National Provider Identifier [NPI]: | 1720005382 |
| Last Name Of The Provider | KASSUBE |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 920 COUNTRY CLUB RD |
| Street Address 2 Of The Provider | SUITE 200A |
| City Of The Provider | EUGENE |
| Zip Code Of The Provider | 974016024 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 88 |
| Number Of Services | 10212 |
| Number Of Medicare Beneficiaries | 325 |
| Total Submitted Charge Amount | 534029.91 |
| Total Medicare Allowed Amount | 201482.51 |
| Total Medicare Payment Amount | 142697.73 |
| Total Medicare Standardized Payment Amount | 147236.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 8647 |
| Number Of Medicare Beneficiaries With Drug Services | 193 |
| Total Drug Submitted ChargeAmount | 59089.91 |
| Total Drug Medicare AllowedAmount | 39317.31 |
| Total Drug Medicare PaymentAmount | 26565.92 |
| Total Drug Medicare Standardized Payment Amount | 26565.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 73 |
| Number Of Medical Services | 1565 |
| Number Of Medicare Beneficiaries With Medical Services | 325 |
| Total Medical Submitted Charge Amount | 474940 |
| Total Medical Medicare Allowed Amount | 162165.2 |
| Total Medical Medicare Payment Amount | 116131.81 |
| Total Medical Medicare Standardized Payment Amount | 120670.38 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 119 |
| Number Of Beneficiaries Age 65 to 74 | 121 |
| Number Of Beneficiaries Age 75 to 84 | 64 |
| Number Of Beneficiaries Age Greater 84 | 21 |
| Number Of Female Beneficiaries | 194 |
| Number Of Male Beneficiaries | 131 |
| Number Of Non Hispanic White Beneficiaries | 310 |
| 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 | 250 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 75 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 71 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0769 |