| National Provider Identifier [NPI]: | 1932171105 |
| Last Name Of The Provider | TANI |
| First Name Of The Provider | PAUL |
| 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 | 17 EXCHANGE ST W |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAINT PAUL |
| Zip Code Of The Provider | 551021222 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 1478 |
| Number Of Medicare Beneficiaries | 274 |
| Total Submitted Charge Amount | 311195 |
| Total Medicare Allowed Amount | 151218.01 |
| Total Medicare Payment Amount | 110279.27 |
| Total Medicare Standardized Payment Amount | 112298.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 184 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 48810 |
| Total Drug Medicare AllowedAmount | 28616.76 |
| Total Drug Medicare PaymentAmount | 22309.44 |
| Total Drug Medicare Standardized Payment Amount | 22309.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 1294 |
| Number Of Medicare Beneficiaries With Medical Services | 274 |
| Total Medical Submitted Charge Amount | 262385 |
| Total Medical Medicare Allowed Amount | 122601.25 |
| Total Medical Medicare Payment Amount | 87969.83 |
| Total Medical Medicare Standardized Payment Amount | 89989.29 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 72 |
| Number Of Beneficiaries Age 75 to 84 | 108 |
| Number Of Beneficiaries Age Greater 84 | 69 |
| Number Of Female Beneficiaries | 161 |
| Number Of Male Beneficiaries | 113 |
| Number Of Non Hispanic White Beneficiaries | 245 |
| 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 | 237 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 37 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3236 |