| National Provider Identifier [NPI]: | 1952307894 |
| Last Name Of The Provider | HANANOUCHI |
| First Name Of The Provider | GLENN |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 231 W FIR AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CLOVIS |
| Zip Code Of The Provider | 936110220 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 133 |
| Number Of Services | 24593 |
| Number Of Medicare Beneficiaries | 2861 |
| Total Submitted Charge Amount | 1211054.4 |
| Total Medicare Allowed Amount | 487103.53 |
| Total Medicare Payment Amount | 399532.97 |
| Total Medicare Standardized Payment Amount | 381054.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 19729 |
| Number Of Medicare Beneficiaries With Drug Services | 262 |
| Total Drug Submitted ChargeAmount | 17954.2 |
| Total Drug Medicare AllowedAmount | 5490.7 |
| Total Drug Medicare PaymentAmount | 4270.48 |
| Total Drug Medicare Standardized Payment Amount | 4270.48 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 131 |
| Number Of Medical Services | 4864 |
| Number Of Medicare Beneficiaries With Medical Services | 2861 |
| Total Medical Submitted Charge Amount | 1193100.2 |
| Total Medical Medicare Allowed Amount | 481612.83 |
| Total Medical Medicare Payment Amount | 395262.49 |
| Total Medical Medicare Standardized Payment Amount | 376783.53 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 287 |
| Number Of Beneficiaries Age 65 to 74 | 1480 |
| Number Of Beneficiaries Age 75 to 84 | 814 |
| Number Of Beneficiaries Age Greater 84 | 280 |
| Number Of Female Beneficiaries | 2016 |
| Number Of Male Beneficiaries | 845 |
| Number Of Non Hispanic White Beneficiaries | 2094 |
| Number Of Black or African American Beneficiaries | 78 |
| Number Of AsianPacific Islander Beneficiaries | 127 |
| Number Of Hispanic Beneficiaries | 468 |
| Number Of American Indian Alaska Native Beneficiaries | 59 |
| Number Of Beneficiaries With Race Not Else where Classified | 35 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2346 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 515 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0874 |