| National Provider Identifier [NPI]: | 1679592372 |
| Last Name Of The Provider | HANSEN |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13907 W CAMINO DEL SOL |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | SUN CITY WEST |
| Zip Code Of The Provider | 853754405 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 88 |
| Number Of Services | 4793 |
| Number Of Medicare Beneficiaries | 880 |
| Total Submitted Charge Amount | 674579.73 |
| Total Medicare Allowed Amount | 282808.18 |
| Total Medicare Payment Amount | 214880.02 |
| Total Medicare Standardized Payment Amount | 217510.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 507 |
| Number Of Medicare Beneficiaries With Drug Services | 50 |
| Total Drug Submitted ChargeAmount | 86531.5 |
| Total Drug Medicare AllowedAmount | 41822.32 |
| Total Drug Medicare PaymentAmount | 32634.49 |
| Total Drug Medicare Standardized Payment Amount | 32634.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 81 |
| Number Of Medical Services | 4286 |
| Number Of Medicare Beneficiaries With Medical Services | 880 |
| Total Medical Submitted Charge Amount | 588048.23 |
| Total Medical Medicare Allowed Amount | 240985.86 |
| Total Medical Medicare Payment Amount | 182245.53 |
| Total Medical Medicare Standardized Payment Amount | 184875.53 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 324 |
| Number Of Beneficiaries Age 75 to 84 | 329 |
| Number Of Beneficiaries Age Greater 84 | 206 |
| Number Of Female Beneficiaries | 217 |
| Number Of Male Beneficiaries | 663 |
| Number Of Non Hispanic White Beneficiaries | 816 |
| Number Of Black or African American Beneficiaries | 26 |
| 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 | 856 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 24 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 26 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4011 |