| National Provider Identifier [NPI]: | 1437335999 |
| Last Name Of The Provider | TAVAREZ |
| First Name Of The Provider | MARIEN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 201 DOCTORS DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | DOTHAN |
| Zip Code Of The Provider | 363012949 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 91 |
| Number Of Services | 22478 |
| Number Of Medicare Beneficiaries | 1017 |
| Total Submitted Charge Amount | 880560 |
| Total Medicare Allowed Amount | 647727.97 |
| Total Medicare Payment Amount | 520129.22 |
| Total Medicare Standardized Payment Amount | 535901.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 5039 |
| Number Of Medicare Beneficiaries With Drug Services | 399 |
| Total Drug Submitted ChargeAmount | 96299 |
| Total Drug Medicare AllowedAmount | 46597.4 |
| Total Drug Medicare PaymentAmount | 37433.26 |
| Total Drug Medicare Standardized Payment Amount | 37433.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 81 |
| Number Of Medical Services | 17439 |
| Number Of Medicare Beneficiaries With Medical Services | 1016 |
| Total Medical Submitted Charge Amount | 784261 |
| Total Medical Medicare Allowed Amount | 601130.57 |
| Total Medical Medicare Payment Amount | 482695.96 |
| Total Medical Medicare Standardized Payment Amount | 498468.38 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 134 |
| Number Of Beneficiaries Age 65 to 74 | 389 |
| Number Of Beneficiaries Age 75 to 84 | 337 |
| Number Of Beneficiaries Age Greater 84 | 157 |
| Number Of Female Beneficiaries | 709 |
| Number Of Male Beneficiaries | 308 |
| Number Of Non Hispanic White Beneficiaries | 877 |
| Number Of Black or African American Beneficiaries | 117 |
| 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 | 798 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 219 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 22 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.2204 |