| National Provider Identifier [NPI]: | 1114916202 |
| Last Name Of The Provider | HUSSAIN |
| First Name Of The Provider | TANVEER |
| 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 | 2351 E 22ND ST |
| Street Address 2 Of The Provider | PSYCHIATRY DEPT |
| City Of The Provider | CLEVELAND |
| Zip Code Of The Provider | 441153111 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 4 |
| Number Of Services | 3168 |
| Number Of Medicare Beneficiaries | 796 |
| Total Submitted Charge Amount | 297500 |
| Total Medicare Allowed Amount | 256792.41 |
| Total Medicare Payment Amount | 189181.87 |
| Total Medicare Standardized Payment Amount | 196014.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 4 |
| Number Of Medical Services | 3168 |
| Number Of Medicare Beneficiaries With Medical Services | 796 |
| Total Medical Submitted Charge Amount | 297500 |
| Total Medical Medicare Allowed Amount | 256792.41 |
| Total Medical Medicare Payment Amount | 189181.87 |
| Total Medical Medicare Standardized Payment Amount | 196014.09 |
| Average Age Of Beneficiaries | 46 |
| Number Of Beneficiaries Age Less65 | 739 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 334 |
| Number Of Male Beneficiaries | 462 |
| Number Of Non Hispanic White Beneficiaries | 569 |
| Number Of Black or African American Beneficiaries | 185 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 197 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 599 |
| Percent Of With Atrial Fibrillation | 2 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 26 |
| Percent Of With Cancer | 3 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 75 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 30 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 54 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.3709 |