| National Provider Identifier [NPI]: | 1174583314 |
| Last Name Of The Provider | HAUSSMANN |
| First Name Of The Provider | ANDREW |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 900 PLAZA DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | MONTOURSVILLE |
| Zip Code Of The Provider | 177542448 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 925 |
| Number Of Medicare Beneficiaries | 567 |
| Total Submitted Charge Amount | 149865 |
| Total Medicare Allowed Amount | 66974.63 |
| Total Medicare Payment Amount | 43009.56 |
| Total Medicare Standardized Payment Amount | 46381.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 55 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 1535 |
| Total Drug Medicare AllowedAmount | 342.29 |
| Total Drug Medicare PaymentAmount | 265.45 |
| Total Drug Medicare Standardized Payment Amount | 265.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 870 |
| Number Of Medicare Beneficiaries With Medical Services | 567 |
| Total Medical Submitted Charge Amount | 148330 |
| Total Medical Medicare Allowed Amount | 66632.34 |
| Total Medical Medicare Payment Amount | 42744.11 |
| Total Medical Medicare Standardized Payment Amount | 46116.2 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 95 |
| Number Of Beneficiaries Age 65 to 74 | 223 |
| Number Of Beneficiaries Age 75 to 84 | 149 |
| Number Of Beneficiaries Age Greater 84 | 100 |
| Number Of Female Beneficiaries | 366 |
| Number Of Male Beneficiaries | 201 |
| Number Of Non Hispanic White Beneficiaries | 555 |
| Number Of Black or African American Beneficiaries | |
| 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 | 487 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 80 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.901 |