| National Provider Identifier [NPI]: | 1043475999 |
| Last Name Of The Provider | TANNER |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2811 TIETON DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | YAKIMA |
| Zip Code Of The Provider | 989023761 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 1526 |
| Number Of Medicare Beneficiaries | 901 |
| Total Submitted Charge Amount | 336612 |
| Total Medicare Allowed Amount | 140198.02 |
| Total Medicare Payment Amount | 107174.87 |
| Total Medicare Standardized Payment Amount | 110005.64 |
| 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 | 38 |
| Number Of Medical Services | 1526 |
| Number Of Medicare Beneficiaries With Medical Services | 901 |
| Total Medical Submitted Charge Amount | 336612 |
| Total Medical Medicare Allowed Amount | 140198.02 |
| Total Medical Medicare Payment Amount | 107174.87 |
| Total Medical Medicare Standardized Payment Amount | 110005.64 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 203 |
| Number Of Beneficiaries Age 65 to 74 | 241 |
| Number Of Beneficiaries Age 75 to 84 | 257 |
| Number Of Beneficiaries Age Greater 84 | 200 |
| Number Of Female Beneficiaries | 523 |
| Number Of Male Beneficiaries | 378 |
| Number Of Non Hispanic White Beneficiaries | 745 |
| Number Of Black or African American Beneficiaries | 17 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 90 |
| Number Of American Indian Alaska Native Beneficiaries | 38 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 576 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 325 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5529 |