| National Provider Identifier [NPI]: | 1801881131 |
| Last Name Of The Provider | SASS |
| First Name Of The Provider | KIRSTEN |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 205 HOSPITAL DR |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | MC KENZIE |
| Zip Code Of The Provider | 382011649 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 128 |
| Number Of Services | 14146 |
| Number Of Medicare Beneficiaries | 502 |
| Total Submitted Charge Amount | 940793 |
| Total Medicare Allowed Amount | 350235.77 |
| Total Medicare Payment Amount | 283583.97 |
| Total Medicare Standardized Payment Amount | 330157.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 19 |
| Number Of Drug Services | 879 |
| Number Of Medicare Beneficiaries With Drug Services | 243 |
| Total Drug Submitted ChargeAmount | 22313 |
| Total Drug Medicare AllowedAmount | 8982.9 |
| Total Drug Medicare PaymentAmount | 8182.04 |
| Total Drug Medicare Standardized Payment Amount | 8182.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 109 |
| Number Of Medical Services | 13267 |
| Number Of Medicare Beneficiaries With Medical Services | 502 |
| Total Medical Submitted Charge Amount | 918480 |
| Total Medical Medicare Allowed Amount | 341252.87 |
| Total Medical Medicare Payment Amount | 275401.93 |
| Total Medical Medicare Standardized Payment Amount | 321975.35 |
| Average Age Of Beneficiaries | 60 |
| Number Of Beneficiaries Age Less65 | 317 |
| Number Of Beneficiaries Age 65 to 74 | 141 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 279 |
| Number Of Male Beneficiaries | 223 |
| Number Of Non Hispanic White Beneficiaries | 452 |
| Number Of Black or African American Beneficiaries | 39 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 175 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 327 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 63 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.3166 |