National Provider Identifier [NPI]: |
1033236237 |
Last Name Of The Provider |
TANARA |
First Name Of The Provider |
KARL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7117 BROCKTON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
RIVERSIDE |
Zip Code Of The Provider |
925062615 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
49 |
Number Of Services |
809 |
Number Of Medicare Beneficiaries |
412 |
Total Submitted Charge Amount |
64896.7 |
Total Medicare Allowed Amount |
39200.23 |
Total Medicare Payment Amount |
26712.86 |
Total Medicare Standardized Payment Amount |
25721.85 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
16 |
Number Of Drug Services |
198 |
Number Of Medicare Beneficiaries With Drug Services |
47 |
Total Drug Submitted ChargeAmount |
465.5 |
Total Drug Medicare AllowedAmount |
174.79 |
Total Drug Medicare PaymentAmount |
127.33 |
Total Drug Medicare Standardized Payment Amount |
127.33 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
611 |
Number Of Medicare Beneficiaries With Medical Services |
412 |
Total Medical Submitted Charge Amount |
64431.2 |
Total Medical Medicare Allowed Amount |
39025.44 |
Total Medical Medicare Payment Amount |
26585.53 |
Total Medical Medicare Standardized Payment Amount |
25594.52 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
177 |
Number Of Beneficiaries Age 75 to 84 |
127 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
271 |
Number Of Male Beneficiaries |
141 |
Number Of Non Hispanic White Beneficiaries |
260 |
Number Of Black or African American Beneficiaries |
56 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
65 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
328 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
84 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.1187 |