| National Provider Identifier [NPI]: | 1710916564 |
| Last Name Of The Provider | TAYARA |
| First Name Of The Provider | WAKKAS |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1391 BROAD AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GULFPORT |
| Zip Code Of The Provider | 395012419 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 106 |
| Number Of Services | 4856 |
| Number Of Medicare Beneficiaries | 1202 |
| Total Submitted Charge Amount | 1510134.9 |
| Total Medicare Allowed Amount | 397663.15 |
| Total Medicare Payment Amount | 294552.62 |
| Total Medicare Standardized Payment Amount | 321410.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 244 |
| Number Of Medicare Beneficiaries With Drug Services | 60 |
| Total Drug Submitted ChargeAmount | 21350 |
| Total Drug Medicare AllowedAmount | 12938.85 |
| Total Drug Medicare PaymentAmount | 9760.39 |
| Total Drug Medicare Standardized Payment Amount | 9760.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 105 |
| Number Of Medical Services | 4612 |
| Number Of Medicare Beneficiaries With Medical Services | 1202 |
| Total Medical Submitted Charge Amount | 1488784.9 |
| Total Medical Medicare Allowed Amount | 384724.3 |
| Total Medical Medicare Payment Amount | 284792.23 |
| Total Medical Medicare Standardized Payment Amount | 311650.08 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 204 |
| Number Of Beneficiaries Age 65 to 74 | 432 |
| Number Of Beneficiaries Age 75 to 84 | 377 |
| Number Of Beneficiaries Age Greater 84 | 189 |
| Number Of Female Beneficiaries | 650 |
| Number Of Male Beneficiaries | 552 |
| Number Of Non Hispanic White Beneficiaries | 944 |
| Number Of Black or African American Beneficiaries | 224 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 852 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 350 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 73 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6953 |