| National Provider Identifier [NPI]: | 1639115397 |
| Last Name Of The Provider | HANNA |
| First Name Of The Provider | YOUSSEF |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1214 RICHARDSON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PORT HURON |
| Zip Code Of The Provider | 480603549 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 114 |
| Number Of Services | 110574 |
| Number Of Medicare Beneficiaries | 900 |
| Total Submitted Charge Amount | 3887643.22 |
| Total Medicare Allowed Amount | 1814085.7 |
| Total Medicare Payment Amount | 1411590.17 |
| Total Medicare Standardized Payment Amount | 1412017.58 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 67 |
| Number Of Drug Services | 102521 |
| Number Of Medicare Beneficiaries With Drug Services | 225 |
| Total Drug Submitted ChargeAmount | 3186327.94 |
| Total Drug Medicare AllowedAmount | 1434997.52 |
| Total Drug Medicare PaymentAmount | 1121283.41 |
| Total Drug Medicare Standardized Payment Amount | 1121283.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 8053 |
| Number Of Medicare Beneficiaries With Medical Services | 900 |
| Total Medical Submitted Charge Amount | 701315.28 |
| Total Medical Medicare Allowed Amount | 379088.18 |
| Total Medical Medicare Payment Amount | 290306.76 |
| Total Medical Medicare Standardized Payment Amount | 290734.17 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 122 |
| Number Of Beneficiaries Age 65 to 74 | 370 |
| Number Of Beneficiaries Age 75 to 84 | 308 |
| Number Of Beneficiaries Age Greater 84 | 100 |
| Number Of Female Beneficiaries | 587 |
| Number Of Male Beneficiaries | 313 |
| Number Of Non Hispanic White Beneficiaries | 841 |
| Number Of Black or African American Beneficiaries | 20 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 736 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 164 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 49 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.9417 |