| National Provider Identifier [NPI]: | 1821092107 |
| Last Name Of The Provider | GENNAOUI |
| First Name Of The Provider | FARES |
| 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 | 289 PLEASANT ST |
| Street Address 2 Of The Provider | STE 101 |
| City Of The Provider | FALL RIVER |
| Zip Code Of The Provider | 027213005 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 90 |
| Number Of Services | 21380 |
| Number Of Medicare Beneficiaries | 2387 |
| Total Submitted Charge Amount | 1890189 |
| Total Medicare Allowed Amount | 429795.34 |
| Total Medicare Payment Amount | 352412.97 |
| Total Medicare Standardized Payment Amount | 337503.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 16900 |
| Number Of Medicare Beneficiaries With Drug Services | 167 |
| Total Drug Submitted ChargeAmount | 16900 |
| Total Drug Medicare AllowedAmount | 3184.5 |
| Total Drug Medicare PaymentAmount | 2480.23 |
| Total Drug Medicare Standardized Payment Amount | 2480.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 89 |
| Number Of Medical Services | 4480 |
| Number Of Medicare Beneficiaries With Medical Services | 2387 |
| Total Medical Submitted Charge Amount | 1873289 |
| Total Medical Medicare Allowed Amount | 426610.84 |
| Total Medical Medicare Payment Amount | 349932.74 |
| Total Medical Medicare Standardized Payment Amount | 335022.85 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 725 |
| Number Of Beneficiaries Age 65 to 74 | 913 |
| Number Of Beneficiaries Age 75 to 84 | 525 |
| Number Of Beneficiaries Age Greater 84 | 224 |
| Number Of Female Beneficiaries | 1734 |
| Number Of Male Beneficiaries | 653 |
| Number Of Non Hispanic White Beneficiaries | 2125 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 177 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 50 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1464 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 923 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1686 |