| National Provider Identifier [NPI]: | 1295742849 |
| Last Name Of The Provider | TANNERU |
| First Name Of The Provider | PADMAJA |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 120 MCMILLEN DRIVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEWARK |
| Zip Code Of The Provider | 43055 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 1993 |
| Number Of Medicare Beneficiaries | 335 |
| Total Submitted Charge Amount | 128146.01 |
| Total Medicare Allowed Amount | 101676.28 |
| Total Medicare Payment Amount | 69093.67 |
| Total Medicare Standardized Payment Amount | 72156.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 271 |
| Number Of Medicare Beneficiaries With Drug Services | 205 |
| Total Drug Submitted ChargeAmount | 5731.01 |
| Total Drug Medicare AllowedAmount | 3521.62 |
| Total Drug Medicare PaymentAmount | 3403.69 |
| Total Drug Medicare Standardized Payment Amount | 3403.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 1722 |
| Number Of Medicare Beneficiaries With Medical Services | 335 |
| Total Medical Submitted Charge Amount | 122415 |
| Total Medical Medicare Allowed Amount | 98154.66 |
| Total Medical Medicare Payment Amount | 65689.98 |
| Total Medical Medicare Standardized Payment Amount | 68753.11 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 97 |
| Number Of Beneficiaries Age 65 to 74 | 109 |
| Number Of Beneficiaries Age 75 to 84 | 83 |
| Number Of Beneficiaries Age Greater 84 | 46 |
| Number Of Female Beneficiaries | 200 |
| Number Of Male Beneficiaries | 135 |
| Number Of Non Hispanic White Beneficiaries | 317 |
| Number Of Black or African American Beneficiaries | |
| 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 | 227 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 108 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2139 |