| National Provider Identifier [NPI]: | 1669415824 |
| Last Name Of The Provider | TANABE |
| First Name Of The Provider | FRED |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 98-1079 MOANALUA ROAD |
| Street Address 2 Of The Provider | SUITE 500 |
| City Of The Provider | AIEA |
| Zip Code Of The Provider | 967014794 |
| State Code Of The Provider | HI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 16 |
| Number Of Services | 2558 |
| Number Of Medicare Beneficiaries | 439 |
| Total Submitted Charge Amount | 220675.44 |
| Total Medicare Allowed Amount | 177661.92 |
| Total Medicare Payment Amount | 119844.62 |
| Total Medicare Standardized Payment Amount | 114448.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 367 |
| Number Of Medicare Beneficiaries With Drug Services | 275 |
| Total Drug Submitted ChargeAmount | 16225 |
| Total Drug Medicare AllowedAmount | 12695.95 |
| Total Drug Medicare PaymentAmount | 11996.93 |
| Total Drug Medicare Standardized Payment Amount | 11996.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 12 |
| Number Of Medical Services | 2191 |
| Number Of Medicare Beneficiaries With Medical Services | 439 |
| Total Medical Submitted Charge Amount | 204450.44 |
| Total Medical Medicare Allowed Amount | 164965.97 |
| Total Medical Medicare Payment Amount | 107847.69 |
| Total Medical Medicare Standardized Payment Amount | 102451.64 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 191 |
| Number Of Beneficiaries Age 75 to 84 | 173 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 241 |
| Number Of Male Beneficiaries | 198 |
| Number Of Non Hispanic White Beneficiaries | 12 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | 353 |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 60 |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 23 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 0.9546 |