| National Provider Identifier [NPI]: | 1699977744 |
| Last Name Of The Provider | HARISARAN |
| First Name Of The Provider | VINCENT |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 450 VETERANS MEMORIAL PKWY |
| Street Address 2 Of The Provider | BLDG 14 |
| City Of The Provider | EAST PROVIDENCE |
| Zip Code Of The Provider | 029145300 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 78 |
| Number Of Services | 3910 |
| Number Of Medicare Beneficiaries | 924 |
| Total Submitted Charge Amount | 610930.16 |
| Total Medicare Allowed Amount | 258406.21 |
| Total Medicare Payment Amount | 192288.25 |
| Total Medicare Standardized Payment Amount | 191503.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 180 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 109237.36 |
| Total Drug Medicare AllowedAmount | 33017.41 |
| Total Drug Medicare PaymentAmount | 25765.68 |
| Total Drug Medicare Standardized Payment Amount | 25765.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 73 |
| Number Of Medical Services | 3730 |
| Number Of Medicare Beneficiaries With Medical Services | 924 |
| Total Medical Submitted Charge Amount | 501692.8 |
| Total Medical Medicare Allowed Amount | 225388.8 |
| Total Medical Medicare Payment Amount | 166522.57 |
| Total Medical Medicare Standardized Payment Amount | 165737.69 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 72 |
| Number Of Beneficiaries Age 65 to 74 | 314 |
| Number Of Beneficiaries Age 75 to 84 | 337 |
| Number Of Beneficiaries Age Greater 84 | 201 |
| Number Of Female Beneficiaries | 115 |
| Number Of Male Beneficiaries | 809 |
| Number Of Non Hispanic White Beneficiaries | 816 |
| Number Of Black or African American Beneficiaries | 30 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 54 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 817 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 107 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 25 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3326 |