National Provider Identifier [NPI]: |
1114162666 |
Last Name Of The Provider |
KASIRYE |
First Name Of The Provider |
YUSUF |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
50 SHERRY AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
PARK FALLS |
Zip Code Of The Provider |
545521467 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
147 |
Number Of Services |
11796 |
Number Of Medicare Beneficiaries |
579 |
Total Submitted Charge Amount |
713488.5 |
Total Medicare Allowed Amount |
289669.73 |
Total Medicare Payment Amount |
210740.82 |
Total Medicare Standardized Payment Amount |
217085.87 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
35 |
Number Of Drug Services |
9346 |
Number Of Medicare Beneficiaries With Drug Services |
245 |
Total Drug Submitted ChargeAmount |
183422.67 |
Total Drug Medicare AllowedAmount |
92827.51 |
Total Drug Medicare PaymentAmount |
64242.63 |
Total Drug Medicare Standardized Payment Amount |
64242.63 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
112 |
Number Of Medical Services |
2450 |
Number Of Medicare Beneficiaries With Medical Services |
578 |
Total Medical Submitted Charge Amount |
530065.83 |
Total Medical Medicare Allowed Amount |
196842.22 |
Total Medical Medicare Payment Amount |
146498.19 |
Total Medical Medicare Standardized Payment Amount |
152843.24 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
121 |
Number Of Beneficiaries Age 65 to 74 |
194 |
Number Of Beneficiaries Age 75 to 84 |
178 |
Number Of Beneficiaries Age Greater 84 |
86 |
Number Of Female Beneficiaries |
298 |
Number Of Male Beneficiaries |
281 |
Number Of Non Hispanic White Beneficiaries |
566 |
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 |
366 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
213 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.424 |