| National Provider Identifier [NPI]: | 1366413320 |
| Last Name Of The Provider | HASAN |
| First Name Of The Provider | GHASSAN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 700 SE 5TH TER |
| Street Address 2 Of The Provider | SUITE 6 |
| City Of The Provider | CRYSTAL RIVER |
| Zip Code Of The Provider | 344294878 |
| 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 | 22 |
| Number Of Services | 540 |
| Number Of Medicare Beneficiaries | 107 |
| Total Submitted Charge Amount | 85200 |
| Total Medicare Allowed Amount | 52747.99 |
| Total Medicare Payment Amount | 39659.91 |
| Total Medicare Standardized Payment Amount | 39674.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 15 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 535 |
| Total Drug Medicare AllowedAmount | 317.29 |
| Total Drug Medicare PaymentAmount | 310.91 |
| Total Drug Medicare Standardized Payment Amount | 310.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 525 |
| Number Of Medicare Beneficiaries With Medical Services | 107 |
| Total Medical Submitted Charge Amount | 84665 |
| Total Medical Medicare Allowed Amount | 52430.7 |
| Total Medical Medicare Payment Amount | 39349 |
| Total Medical Medicare Standardized Payment Amount | 39363.99 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 13 |
| Number Of Beneficiaries Age 65 to 74 | 45 |
| Number Of Beneficiaries Age 75 to 84 | 32 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 52 |
| Number Of Male Beneficiaries | 55 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 83 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 24 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 68 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2975 |