| National Provider Identifier [NPI]: | 1750591053 |
| Last Name Of The Provider | TANNEHILL |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 621 S NEW BALLAS RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CREVE COEUR |
| Zip Code Of The Provider | 631418232 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Critical Care (Intensivists) |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 17 |
| Number Of Services | 547 |
| Number Of Medicare Beneficiaries | 227 |
| Total Submitted Charge Amount | 247801 |
| Total Medicare Allowed Amount | 88628.67 |
| Total Medicare Payment Amount | 68741.02 |
| Total Medicare Standardized Payment Amount | 70024.63 |
| 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 | 17 |
| Number Of Medical Services | 547 |
| Number Of Medicare Beneficiaries With Medical Services | 227 |
| Total Medical Submitted Charge Amount | 247801 |
| Total Medical Medicare Allowed Amount | 88628.67 |
| Total Medical Medicare Payment Amount | 68741.02 |
| Total Medical Medicare Standardized Payment Amount | 70024.63 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 48 |
| Number Of Beneficiaries Age 65 to 74 | 75 |
| Number Of Beneficiaries Age 75 to 84 | 66 |
| Number Of Beneficiaries Age Greater 84 | 38 |
| Number Of Female Beneficiaries | 107 |
| Number Of Male Beneficiaries | 120 |
| Number Of Non Hispanic White Beneficiaries | 201 |
| 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 | 176 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 51 |
| Percent Of With Atrial Fibrillation | 37 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 59 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 45 |
| Percent Of With Depression | 54 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 20 |
| Average HCC Risk Score Of Beneficiaries | 2.5802 |