| National Provider Identifier [NPI]: | 1043486137 |
| Last Name Of The Provider | HANNON |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 120 S SPALDING DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | BEVERLY HILLS |
| Zip Code Of The Provider | 902121800 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 303 |
| Number Of Medicare Beneficiaries | 56 |
| Total Submitted Charge Amount | 41602.57 |
| Total Medicare Allowed Amount | 16532.24 |
| Total Medicare Payment Amount | 12730.8 |
| Total Medicare Standardized Payment Amount | 11728.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 144 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 1126.59 |
| Total Drug Medicare AllowedAmount | 665.92 |
| Total Drug Medicare PaymentAmount | 522.11 |
| Total Drug Medicare Standardized Payment Amount | 522.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 159 |
| Number Of Medicare Beneficiaries With Medical Services | 56 |
| Total Medical Submitted Charge Amount | 40475.98 |
| Total Medical Medicare Allowed Amount | 15866.32 |
| Total Medical Medicare Payment Amount | 12208.69 |
| Total Medical Medicare Standardized Payment Amount | 11206.27 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 17 |
| Number Of Beneficiaries Age 75 to 84 | 20 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 33 |
| Number Of Male Beneficiaries | 23 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 40 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 68 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4135 |