| National Provider Identifier [NPI]: | 1588691950 |
| Last Name Of The Provider | ANANICH |
| First Name Of The Provider | MARINA |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3037 SILVERWOOD DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAGINAW |
| Zip Code Of The Provider | 486032171 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 168 |
| Number Of Services | 4340 |
| Number Of Medicare Beneficiaries | 2591 |
| Total Submitted Charge Amount | 692576 |
| Total Medicare Allowed Amount | 191574.63 |
| Total Medicare Payment Amount | 144758.45 |
| Total Medicare Standardized Payment Amount | 149781.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 168 |
| Number Of Medical Services | 4340 |
| Number Of Medicare Beneficiaries With Medical Services | 2591 |
| Total Medical Submitted Charge Amount | 692576 |
| Total Medical Medicare Allowed Amount | 191574.63 |
| Total Medical Medicare Payment Amount | 144758.45 |
| Total Medical Medicare Standardized Payment Amount | 149781.17 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 524 |
| Number Of Beneficiaries Age 65 to 74 | 978 |
| Number Of Beneficiaries Age 75 to 84 | 745 |
| Number Of Beneficiaries Age Greater 84 | 344 |
| Number Of Female Beneficiaries | 1404 |
| Number Of Male Beneficiaries | 1187 |
| Number Of Non Hispanic White Beneficiaries | 2467 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | 79 |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1949 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 642 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.4792 |