| National Provider Identifier [NPI]: | 1780678649 |
| Last Name Of The Provider | RYAN |
| First Name Of The Provider | ANNA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1650 ELM ST |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | MANCHESTER |
| Zip Code Of The Provider | 031011217 |
| State Code Of The Provider | NH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 3076 |
| Number Of Medicare Beneficiaries | 814 |
| Total Submitted Charge Amount | 594282 |
| Total Medicare Allowed Amount | 220139.39 |
| Total Medicare Payment Amount | 157942.33 |
| Total Medicare Standardized Payment Amount | 151906.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 15 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 120 |
| Total Drug Medicare AllowedAmount | 26.86 |
| Total Drug Medicare PaymentAmount | 16.76 |
| Total Drug Medicare Standardized Payment Amount | 16.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 62 |
| Number Of Medical Services | 3061 |
| Number Of Medicare Beneficiaries With Medical Services | 814 |
| Total Medical Submitted Charge Amount | 594162 |
| Total Medical Medicare Allowed Amount | 220112.53 |
| Total Medical Medicare Payment Amount | 157925.57 |
| Total Medical Medicare Standardized Payment Amount | 151889.66 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 32 |
| Number Of Beneficiaries Age 65 to 74 | 228 |
| Number Of Beneficiaries Age 75 to 84 | 357 |
| Number Of Beneficiaries Age Greater 84 | 197 |
| Number Of Female Beneficiaries | 534 |
| Number Of Male Beneficiaries | 280 |
| Number Of Non Hispanic White Beneficiaries | 798 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 784 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 30 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9105 |