| National Provider Identifier [NPI]: | 1770541229 |
| Last Name Of The Provider | TAHHAN |
| First Name Of The Provider | HASSAN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 600 GRESHAM DR |
| Street Address 2 Of The Provider | SENTARA NORFOLK GENERAL HOSPITAL PATH DEPT |
| City Of The Provider | NORFOLK |
| Zip Code Of The Provider | 235071904 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 12 |
| Number Of Services | 4701 |
| Number Of Medicare Beneficiaries | 2612 |
| Total Submitted Charge Amount | 349922 |
| Total Medicare Allowed Amount | 106080.17 |
| Total Medicare Payment Amount | 82896.94 |
| Total Medicare Standardized Payment Amount | 76822.56 |
| 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 | 12 |
| Number Of Medical Services | 4701 |
| Number Of Medicare Beneficiaries With Medical Services | 2612 |
| Total Medical Submitted Charge Amount | 349922 |
| Total Medical Medicare Allowed Amount | 106080.17 |
| Total Medical Medicare Payment Amount | 82896.94 |
| Total Medical Medicare Standardized Payment Amount | 76822.56 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 520 |
| Number Of Beneficiaries Age 65 to 74 | 866 |
| Number Of Beneficiaries Age 75 to 84 | 785 |
| Number Of Beneficiaries Age Greater 84 | 441 |
| Number Of Female Beneficiaries | 1383 |
| Number Of Male Beneficiaries | 1229 |
| Number Of Non Hispanic White Beneficiaries | 1593 |
| Number Of Black or African American Beneficiaries | 890 |
| Number Of AsianPacific Islander Beneficiaries | 52 |
| 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 | 1991 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 621 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 60 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.3915 |