| National Provider Identifier [NPI]: | 1932317054 |
| Last Name Of The Provider | MASSA |
| First Name Of The Provider | LUIZ |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1361 13TH AVE S |
| Street Address 2 Of The Provider | SUITE 250 |
| City Of The Provider | JACKSONVILLE BEACH |
| Zip Code Of The Provider | 322503233 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 7822 |
| Number Of Medicare Beneficiaries | 519 |
| Total Submitted Charge Amount | 990308 |
| Total Medicare Allowed Amount | 475102.36 |
| Total Medicare Payment Amount | 360906.2 |
| Total Medicare Standardized Payment Amount | 366257.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 2597 |
| Number Of Medicare Beneficiaries With Drug Services | 152 |
| Total Drug Submitted ChargeAmount | 30145 |
| Total Drug Medicare AllowedAmount | 18785.95 |
| Total Drug Medicare PaymentAmount | 14688.89 |
| Total Drug Medicare Standardized Payment Amount | 14688.89 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 5225 |
| Number Of Medicare Beneficiaries With Medical Services | 519 |
| Total Medical Submitted Charge Amount | 960163 |
| Total Medical Medicare Allowed Amount | 456316.41 |
| Total Medical Medicare Payment Amount | 346217.31 |
| Total Medical Medicare Standardized Payment Amount | 351568.59 |
| Average Age Of Beneficiaries | 60 |
| Number Of Beneficiaries Age Less65 | 319 |
| Number Of Beneficiaries Age 65 to 74 | 135 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 324 |
| Number Of Male Beneficiaries | 195 |
| Number Of Non Hispanic White Beneficiaries | 428 |
| Number Of Black or African American Beneficiaries | 57 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 355 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 164 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.4621 |