| National Provider Identifier [NPI]: | 1306183702 |
| Last Name Of The Provider | FOSTER |
| First Name Of The Provider | TANJA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 816 W CANNON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT WORTH |
| Zip Code Of The Provider | 761043146 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 122 |
| Number Of Services | 2844 |
| Number Of Medicare Beneficiaries | 1644 |
| Total Submitted Charge Amount | 367670.46 |
| Total Medicare Allowed Amount | 73216.8 |
| Total Medicare Payment Amount | 55834.01 |
| Total Medicare Standardized Payment Amount | 60264.56 |
| Drug Suppress Indicator | * |
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| Number Of Medicare Beneficiaries With Drug Services | |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
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| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 340 |
| Number Of Beneficiaries Age 65 to 74 | 563 |
| Number Of Beneficiaries Age 75 to 84 | 461 |
| Number Of Beneficiaries Age Greater 84 | 280 |
| Number Of Female Beneficiaries | 893 |
| Number Of Male Beneficiaries | 751 |
| Number Of Non Hispanic White Beneficiaries | 1384 |
| Number Of Black or African American Beneficiaries | 230 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1227 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 417 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 52 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.029 |