| National Provider Identifier [NPI]: | 1497765325 |
| Last Name Of The Provider | JAMAL |
| First Name Of The Provider | KASSAMALI |
| 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 | 604 9TH ST N |
| Street Address 2 Of The Provider | |
| City Of The Provider | VIRGINIA |
| Zip Code Of The Provider | 557922320 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 81 |
| Number Of Services | 4929 |
| Number Of Medicare Beneficiaries | 169 |
| Total Submitted Charge Amount | 468336.64 |
| Total Medicare Allowed Amount | 183613.34 |
| Total Medicare Payment Amount | 137517.16 |
| Total Medicare Standardized Payment Amount | 138880.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 1898 |
| Number Of Medicare Beneficiaries With Drug Services | 114 |
| Total Drug Submitted ChargeAmount | 32588.24 |
| Total Drug Medicare AllowedAmount | 12298.81 |
| Total Drug Medicare PaymentAmount | 10134.88 |
| Total Drug Medicare Standardized Payment Amount | 10134.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 66 |
| Number Of Medical Services | 3031 |
| Number Of Medicare Beneficiaries With Medical Services | 169 |
| Total Medical Submitted Charge Amount | 435748.4 |
| Total Medical Medicare Allowed Amount | 171314.53 |
| Total Medical Medicare Payment Amount | 127382.28 |
| Total Medical Medicare Standardized Payment Amount | 128745.94 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 95 |
| Number Of Beneficiaries Age 65 to 74 | 38 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 87 |
| Number Of Male Beneficiaries | 82 |
| Number Of Non Hispanic White Beneficiaries | 151 |
| 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 | 88 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 81 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 43 |
| Percent Of With Depression | 61 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 28 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 20 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4644 |