| National Provider Identifier [NPI]: | 1982697884 |
| Last Name Of The Provider | HANSEN |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | PA C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9500 INDEPENDENCE DR |
| Street Address 2 Of The Provider | STE 900 |
| City Of The Provider | ANCHORAGE |
| Zip Code Of The Provider | 995074600 |
| State Code Of The Provider | AK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 1392 |
| Number Of Medicare Beneficiaries | 177 |
| Total Submitted Charge Amount | 113960 |
| Total Medicare Allowed Amount | 46692.3 |
| Total Medicare Payment Amount | 31781.75 |
| Total Medicare Standardized Payment Amount | 31175.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 23 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 880 |
| Total Drug Medicare AllowedAmount | 652.52 |
| Total Drug Medicare PaymentAmount | 617.56 |
| Total Drug Medicare Standardized Payment Amount | 617.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 1369 |
| Number Of Medicare Beneficiaries With Medical Services | 177 |
| Total Medical Submitted Charge Amount | 113080 |
| Total Medical Medicare Allowed Amount | 46039.78 |
| Total Medical Medicare Payment Amount | 31164.19 |
| Total Medical Medicare Standardized Payment Amount | 30558.22 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 92 |
| Number Of Beneficiaries Age 75 to 84 | 48 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 92 |
| Number Of Male Beneficiaries | 85 |
| Number Of Non Hispanic White Beneficiaries | 150 |
| 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 | 145 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 32 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7758 |