| National Provider Identifier [NPI]: | 1366698144 |
| Last Name Of The Provider | FANANAPAZIR |
| First Name Of The Provider | GHANEH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2100 ERWIN RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | DURHAM |
| Zip Code Of The Provider | 277053941 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 95 |
| Number Of Services | 2131 |
| Number Of Medicare Beneficiaries | 1603 |
| Total Submitted Charge Amount | 583495 |
| Total Medicare Allowed Amount | 103026.59 |
| Total Medicare Payment Amount | 78711.03 |
| Total Medicare Standardized Payment Amount | 77313.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 95 |
| Number Of Medical Services | 2131 |
| Number Of Medicare Beneficiaries With Medical Services | 1603 |
| Total Medical Submitted Charge Amount | 583495 |
| Total Medical Medicare Allowed Amount | 103026.59 |
| Total Medical Medicare Payment Amount | 78711.03 |
| Total Medical Medicare Standardized Payment Amount | 77313.23 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 503 |
| Number Of Beneficiaries Age 65 to 74 | 600 |
| Number Of Beneficiaries Age 75 to 84 | 340 |
| Number Of Beneficiaries Age Greater 84 | 160 |
| Number Of Female Beneficiaries | 788 |
| Number Of Male Beneficiaries | 815 |
| Number Of Non Hispanic White Beneficiaries | 1038 |
| Number Of Black or African American Beneficiaries | 193 |
| Number Of AsianPacific Islander Beneficiaries | 155 |
| Number Of Hispanic Beneficiaries | 180 |
| Number Of American Indian Alaska Native Beneficiaries | 12 |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 922 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 681 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 2.3944 |