| National Provider Identifier [NPI]: | 1760441422 |
| Last Name Of The Provider | HANSEN |
| First Name Of The Provider | DONALD |
| 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 | 330 WASHINGTON STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | WEYMOUTH |
| Zip Code Of The Provider | 02188 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 693 |
| Number Of Medicare Beneficiaries | 422 |
| Total Submitted Charge Amount | 129310 |
| Total Medicare Allowed Amount | 66541.27 |
| Total Medicare Payment Amount | 48626.58 |
| Total Medicare Standardized Payment Amount | 45664.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 25 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 569 |
| Total Drug Medicare AllowedAmount | 196.03 |
| Total Drug Medicare PaymentAmount | 163.14 |
| Total Drug Medicare Standardized Payment Amount | 163.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 668 |
| Number Of Medicare Beneficiaries With Medical Services | 422 |
| Total Medical Submitted Charge Amount | 128741 |
| Total Medical Medicare Allowed Amount | 66345.24 |
| Total Medical Medicare Payment Amount | 48463.44 |
| Total Medical Medicare Standardized Payment Amount | 45501.23 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 52 |
| Number Of Beneficiaries Age 65 to 74 | 212 |
| Number Of Beneficiaries Age 75 to 84 | 106 |
| Number Of Beneficiaries Age Greater 84 | 52 |
| Number Of Female Beneficiaries | 274 |
| Number Of Male Beneficiaries | 148 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 362 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 60 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9718 |