| National Provider Identifier [NPI]: | 1275579401 |
| Last Name Of The Provider | TATINENI |
| First Name Of The Provider | SUVEER |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1325 N HIGHLAND AVE |
| Street Address 2 Of The Provider | PROVENA MERCY MEDICAL CENTER/RADIOLOGY DEPARTMENT |
| City Of The Provider | AURORA |
| Zip Code Of The Provider | 605061449 |
| 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 | 241 |
| Number Of Services | 2437 |
| Number Of Medicare Beneficiaries | 1227 |
| Total Submitted Charge Amount | 732010.32 |
| Total Medicare Allowed Amount | 172764.05 |
| Total Medicare Payment Amount | 135366.02 |
| Total Medicare Standardized Payment Amount | 125186.13 |
| 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 | 241 |
| Number Of Medical Services | 2437 |
| Number Of Medicare Beneficiaries With Medical Services | 1227 |
| Total Medical Submitted Charge Amount | 732010.32 |
| Total Medical Medicare Allowed Amount | 172764.05 |
| Total Medical Medicare Payment Amount | 135366.02 |
| Total Medical Medicare Standardized Payment Amount | 125186.13 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 248 |
| Number Of Beneficiaries Age 65 to 74 | 437 |
| Number Of Beneficiaries Age 75 to 84 | 348 |
| Number Of Beneficiaries Age Greater 84 | 194 |
| Number Of Female Beneficiaries | 745 |
| Number Of Male Beneficiaries | 482 |
| Number Of Non Hispanic White Beneficiaries | 941 |
| Number Of Black or African American Beneficiaries | 115 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 148 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 807 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 420 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.102 |