| National Provider Identifier [NPI]: | 1427212026 |
| Last Name Of The Provider | HUSSAIN |
| First Name Of The Provider | TASSAWAR |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2900 16TH ST |
| Street Address 2 Of The Provider | INDIANA UNIVERSITY HEALTH BEDFORD HOSPITAL |
| City Of The Provider | BEDFORD |
| Zip Code Of The Provider | 474213510 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 2146 |
| Number Of Medicare Beneficiaries | 628 |
| Total Submitted Charge Amount | 208303.69 |
| Total Medicare Allowed Amount | 157049.27 |
| Total Medicare Payment Amount | 106961.64 |
| Total Medicare Standardized Payment Amount | 114748.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 122 |
| Number Of Medicare Beneficiaries With Drug Services | 97 |
| Total Drug Submitted ChargeAmount | 2891.41 |
| Total Drug Medicare AllowedAmount | 2689.1 |
| Total Drug Medicare PaymentAmount | 2584.27 |
| Total Drug Medicare Standardized Payment Amount | 2584.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 2024 |
| Number Of Medicare Beneficiaries With Medical Services | 628 |
| Total Medical Submitted Charge Amount | 205412.28 |
| Total Medical Medicare Allowed Amount | 154360.17 |
| Total Medical Medicare Payment Amount | 104377.37 |
| Total Medical Medicare Standardized Payment Amount | 112163.93 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 144 |
| Number Of Beneficiaries Age 65 to 74 | 238 |
| Number Of Beneficiaries Age 75 to 84 | 139 |
| Number Of Beneficiaries Age Greater 84 | 107 |
| Number Of Female Beneficiaries | 335 |
| Number Of Male Beneficiaries | 293 |
| Number Of Non Hispanic White Beneficiaries | 616 |
| Number Of Black or African American Beneficiaries | |
| 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 | 434 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 194 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2403 |