| National Provider Identifier [NPI]: | 1679649271 |
| Last Name Of The Provider | HANISSIAN |
| First Name Of The Provider | ARA |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 574 GREEN TREE CV |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | COLLIERVILLE |
| Zip Code Of The Provider | 380172562 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 102 |
| Number Of Services | 16047 |
| Number Of Medicare Beneficiaries | 349 |
| Total Submitted Charge Amount | 886398 |
| Total Medicare Allowed Amount | 327900.19 |
| Total Medicare Payment Amount | 268390.1 |
| Total Medicare Standardized Payment Amount | 294308.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 887 |
| Number Of Medicare Beneficiaries With Drug Services | 176 |
| Total Drug Submitted ChargeAmount | 25625 |
| Total Drug Medicare AllowedAmount | 5704.67 |
| Total Drug Medicare PaymentAmount | 4564.55 |
| Total Drug Medicare Standardized Payment Amount | 4564.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 88 |
| Number Of Medical Services | 15160 |
| Number Of Medicare Beneficiaries With Medical Services | 349 |
| Total Medical Submitted Charge Amount | 860773 |
| Total Medical Medicare Allowed Amount | 322195.52 |
| Total Medical Medicare Payment Amount | 263825.55 |
| Total Medical Medicare Standardized Payment Amount | 289744.04 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 212 |
| Number Of Beneficiaries Age 75 to 84 | 80 |
| Number Of Beneficiaries Age Greater 84 | 30 |
| Number Of Female Beneficiaries | 152 |
| Number Of Male Beneficiaries | 197 |
| Number Of Non Hispanic White Beneficiaries | 327 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9776 |