| National Provider Identifier [NPI]: | 1427310440 |
| Last Name Of The Provider | SASSE |
| First Name Of The Provider | ELIZABETH |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 661 E ALTAMONTE DR |
| Street Address 2 Of The Provider | SUITE 115 |
| City Of The Provider | ALTAMONTE SPRINGS |
| Zip Code Of The Provider | 327015105 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 1811 |
| Number Of Medicare Beneficiaries | 263 |
| Total Submitted Charge Amount | 257740 |
| Total Medicare Allowed Amount | 107450.8 |
| Total Medicare Payment Amount | 81686.39 |
| Total Medicare Standardized Payment Amount | 83501.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 757 |
| Number Of Medicare Beneficiaries With Drug Services | 154 |
| Total Drug Submitted ChargeAmount | 50681 |
| Total Drug Medicare AllowedAmount | 19068.31 |
| Total Drug Medicare PaymentAmount | 17296.47 |
| Total Drug Medicare Standardized Payment Amount | 17296.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 1054 |
| Number Of Medicare Beneficiaries With Medical Services | 261 |
| Total Medical Submitted Charge Amount | 207059 |
| Total Medical Medicare Allowed Amount | 88382.49 |
| Total Medical Medicare Payment Amount | 64389.92 |
| Total Medical Medicare Standardized Payment Amount | 66205.06 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 134 |
| Number Of Beneficiaries Age 75 to 84 | 85 |
| Number Of Beneficiaries Age Greater 84 | 22 |
| Number Of Female Beneficiaries | 193 |
| Number Of Male Beneficiaries | 70 |
| Number Of Non Hispanic White Beneficiaries | 221 |
| Number Of Black or African American Beneficiaries | 27 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 245 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0394 |