| National Provider Identifier [NPI]: | 1194764720 |
| Last Name Of The Provider | TANAKA |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 600 COFFEE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MODESTO |
| Zip Code Of The Provider | 953554201 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 3681 |
| Number Of Medicare Beneficiaries | 1072 |
| Total Submitted Charge Amount | 981993.2 |
| Total Medicare Allowed Amount | 333742.98 |
| Total Medicare Payment Amount | 247791.1 |
| Total Medicare Standardized Payment Amount | 241548 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 47 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 1039.2 |
| Total Drug Medicare AllowedAmount | 520.58 |
| Total Drug Medicare PaymentAmount | 504.38 |
| Total Drug Medicare Standardized Payment Amount | 504.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 3634 |
| Number Of Medicare Beneficiaries With Medical Services | 1072 |
| Total Medical Submitted Charge Amount | 980954 |
| Total Medical Medicare Allowed Amount | 333222.4 |
| Total Medical Medicare Payment Amount | 247286.72 |
| Total Medical Medicare Standardized Payment Amount | 241043.62 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 181 |
| Number Of Beneficiaries Age 65 to 74 | 448 |
| Number Of Beneficiaries Age 75 to 84 | 336 |
| Number Of Beneficiaries Age Greater 84 | 107 |
| Number Of Female Beneficiaries | 601 |
| Number Of Male Beneficiaries | 471 |
| Number Of Non Hispanic White Beneficiaries | 851 |
| Number Of Black or African American Beneficiaries | 31 |
| Number Of AsianPacific Islander Beneficiaries | 39 |
| Number Of Hispanic Beneficiaries | 125 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 736 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 336 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 24 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 56 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.7758 |