| National Provider Identifier [NPI]: | 1891716718 |
| Last Name Of The Provider | GANESAN |
| First Name Of The Provider | PALVANNANATHAN |
| 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 | 4242 FARNAM ST |
| Street Address 2 Of The Provider | #470 |
| City Of The Provider | OMAHA |
| Zip Code Of The Provider | 681312806 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 2875 |
| Number Of Medicare Beneficiaries | 760 |
| Total Submitted Charge Amount | 342247.5 |
| Total Medicare Allowed Amount | 227360.85 |
| Total Medicare Payment Amount | 176208.21 |
| Total Medicare Standardized Payment Amount | 187080.95 |
| Drug Suppress Indicator | * |
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| Number Of Drug Services | |
| Number Of Medicare Beneficiaries With Drug Services | |
| Total Drug Submitted ChargeAmount | |
| Total Drug Medicare AllowedAmount | |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
| Number Of Medical Services | |
| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Total Medical Medicare Standardized Payment Amount | |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 99 |
| Number Of Beneficiaries Age 65 to 74 | 302 |
| Number Of Beneficiaries Age 75 to 84 | 262 |
| Number Of Beneficiaries Age Greater 84 | 97 |
| Number Of Female Beneficiaries | 372 |
| Number Of Male Beneficiaries | 388 |
| Number Of Non Hispanic White Beneficiaries | 696 |
| Number Of Black or African American Beneficiaries | 31 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 601 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 159 |
| Percent Of With Atrial Fibrillation | 34 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 47 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.8357 |