| National Provider Identifier [NPI]: | 1104879212 |
| Last Name Of The Provider | TARTER |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 180 SOUTH THIRD STREET |
| Street Address 2 Of The Provider | STE 101 |
| City Of The Provider | BELLEVILLE |
| Zip Code Of The Provider | 62220 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 195 |
| Number Of Services | 6107 |
| Number Of Medicare Beneficiaries | 2301 |
| Total Submitted Charge Amount | 366358.5 |
| Total Medicare Allowed Amount | 158893.59 |
| Total Medicare Payment Amount | 125720.82 |
| Total Medicare Standardized Payment Amount | 129170.76 |
| 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 | 195 |
| Number Of Medical Services | 6107 |
| Number Of Medicare Beneficiaries With Medical Services | 2301 |
| Total Medical Submitted Charge Amount | 366358.5 |
| Total Medical Medicare Allowed Amount | 158893.59 |
| Total Medical Medicare Payment Amount | 125720.82 |
| Total Medical Medicare Standardized Payment Amount | 129170.76 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 364 |
| Number Of Beneficiaries Age 65 to 74 | 944 |
| Number Of Beneficiaries Age 75 to 84 | 710 |
| Number Of Beneficiaries Age Greater 84 | 283 |
| Number Of Female Beneficiaries | 1558 |
| Number Of Male Beneficiaries | 743 |
| Number Of Non Hispanic White Beneficiaries | 2193 |
| Number Of Black or African American Beneficiaries | 81 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1690 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 611 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2196 |