| National Provider Identifier [NPI]: | 1295798635 |
| Last Name Of The Provider | KASS |
| First Name Of The Provider | SIDNEY |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7104 W LAKE ST |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | ST LOUIS PARK |
| Zip Code Of The Provider | 554264417 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Anesthesiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 1395 |
| Number Of Medicare Beneficiaries | 248 |
| Total Submitted Charge Amount | 375123.13 |
| Total Medicare Allowed Amount | 102057.93 |
| Total Medicare Payment Amount | 76464.13 |
| Total Medicare Standardized Payment Amount | 76624.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 527 |
| Number Of Medicare Beneficiaries With Drug Services | 77 |
| Total Drug Submitted ChargeAmount | 39141.51 |
| Total Drug Medicare AllowedAmount | 10387.05 |
| Total Drug Medicare PaymentAmount | 7919.68 |
| Total Drug Medicare Standardized Payment Amount | 7919.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 868 |
| Number Of Medicare Beneficiaries With Medical Services | 247 |
| Total Medical Submitted Charge Amount | 335981.62 |
| Total Medical Medicare Allowed Amount | 91670.88 |
| Total Medical Medicare Payment Amount | 68544.45 |
| Total Medical Medicare Standardized Payment Amount | 68704.88 |
| Average Age Of Beneficiaries | 60 |
| Number Of Beneficiaries Age Less65 | 140 |
| Number Of Beneficiaries Age 65 to 74 | 63 |
| Number Of Beneficiaries Age 75 to 84 | 30 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 160 |
| Number Of Male Beneficiaries | 88 |
| Number Of Non Hispanic White Beneficiaries | 216 |
| Number Of Black or African American Beneficiaries | 18 |
| 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 | 138 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 110 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 49 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 27 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 65 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.5396 |