| National Provider Identifier [NPI]: | 1003921404 |
| Last Name Of The Provider | TANNER |
| First Name Of The Provider | PAUL |
| 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 | 6019 WALNUT GROVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MEMPHIS |
| Zip Code Of The Provider | 38120 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 162 |
| Number Of Services | 8994 |
| Number Of Medicare Beneficiaries | 6119 |
| Total Submitted Charge Amount | 905196 |
| Total Medicare Allowed Amount | 235743.39 |
| Total Medicare Payment Amount | 176523.07 |
| Total Medicare Standardized Payment Amount | 188451.31 |
| 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 | 162 |
| Number Of Medical Services | 8994 |
| Number Of Medicare Beneficiaries With Medical Services | 6119 |
| Total Medical Submitted Charge Amount | 905196 |
| Total Medical Medicare Allowed Amount | 235743.39 |
| Total Medical Medicare Payment Amount | 176523.07 |
| Total Medical Medicare Standardized Payment Amount | 188451.31 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 1066 |
| Number Of Beneficiaries Age 65 to 74 | 2324 |
| Number Of Beneficiaries Age 75 to 84 | 1821 |
| Number Of Beneficiaries Age Greater 84 | 908 |
| Number Of Female Beneficiaries | 3600 |
| Number Of Male Beneficiaries | 2519 |
| Number Of Non Hispanic White Beneficiaries | 4552 |
| Number Of Black or African American Beneficiaries | 1453 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 42 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 36 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4595 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1524 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8726 |