| National Provider Identifier [NPI]: | 1942248083 |
| Last Name Of The Provider | HANTASH |
| First Name Of The Provider | BASIL |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD, PHD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3800 GEER RD |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | TURLOCK |
| Zip Code Of The Provider | 953821146 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 86 |
| Number Of Services | 14443 |
| Number Of Medicare Beneficiaries | 1461 |
| Total Submitted Charge Amount | 1966229 |
| Total Medicare Allowed Amount | 847036.26 |
| Total Medicare Payment Amount | 624295.19 |
| Total Medicare Standardized Payment Amount | 572562.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 805 |
| Number Of Medicare Beneficiaries With Drug Services | 109 |
| Total Drug Submitted ChargeAmount | 22260 |
| Total Drug Medicare AllowedAmount | 8409.7 |
| Total Drug Medicare PaymentAmount | 6509.95 |
| Total Drug Medicare Standardized Payment Amount | 6509.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 84 |
| Number Of Medical Services | 13638 |
| Number Of Medicare Beneficiaries With Medical Services | 1461 |
| Total Medical Submitted Charge Amount | 1943969 |
| Total Medical Medicare Allowed Amount | 838626.56 |
| Total Medical Medicare Payment Amount | 617785.24 |
| Total Medical Medicare Standardized Payment Amount | 566052.59 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 94 |
| Number Of Beneficiaries Age 65 to 74 | 632 |
| Number Of Beneficiaries Age 75 to 84 | 485 |
| Number Of Beneficiaries Age Greater 84 | 250 |
| Number Of Female Beneficiaries | 793 |
| Number Of Male Beneficiaries | 668 |
| Number Of Non Hispanic White Beneficiaries | 1268 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 41 |
| Number Of Hispanic Beneficiaries | 122 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1182 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 279 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0672 |