| National Provider Identifier [NPI]: | 1679796783 |
| Last Name Of The Provider | HANISCH |
| First Name Of The Provider | RYAN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3226 S ALAMEDA ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CORPUS CHRISTI |
| Zip Code Of The Provider | 784042508 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 165 |
| Number Of Services | 6741 |
| Number Of Medicare Beneficiaries | 3723 |
| Total Submitted Charge Amount | 653057.7 |
| Total Medicare Allowed Amount | 190769.66 |
| Total Medicare Payment Amount | 139904.63 |
| Total Medicare Standardized Payment Amount | 148098.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 183 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 700.7 |
| Total Drug Medicare AllowedAmount | 365.52 |
| Total Drug Medicare PaymentAmount | 286.59 |
| Total Drug Medicare Standardized Payment Amount | 286.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 162 |
| Number Of Medical Services | 6558 |
| Number Of Medicare Beneficiaries With Medical Services | 3723 |
| Total Medical Submitted Charge Amount | 652357 |
| Total Medical Medicare Allowed Amount | 190404.14 |
| Total Medical Medicare Payment Amount | 139618.04 |
| Total Medical Medicare Standardized Payment Amount | 147811.67 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 938 |
| Number Of Beneficiaries Age 65 to 74 | 1098 |
| Number Of Beneficiaries Age 75 to 84 | 1028 |
| Number Of Beneficiaries Age Greater 84 | 659 |
| Number Of Female Beneficiaries | 2053 |
| Number Of Male Beneficiaries | 1670 |
| Number Of Non Hispanic White Beneficiaries | 1560 |
| Number Of Black or African American Beneficiaries | 135 |
| Number Of AsianPacific Islander Beneficiaries | 28 |
| Number Of Hispanic Beneficiaries | 1978 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1939 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1784 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 33 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.3901 |