| National Provider Identifier [NPI]: | 1790850097 |
| Last Name Of The Provider | TAVARES |
| First Name Of The Provider | JOSEPH |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 322 WARREN ST |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | JOHNSTOWN |
| Zip Code Of The Provider | 159053443 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 565 |
| Number Of Medicare Beneficiaries | 105 |
| Total Submitted Charge Amount | 35565 |
| Total Medicare Allowed Amount | 23408.24 |
| Total Medicare Payment Amount | 18423.02 |
| Total Medicare Standardized Payment Amount | 19394.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 59 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 1424 |
| Total Drug Medicare AllowedAmount | 692.98 |
| Total Drug Medicare PaymentAmount | 672.97 |
| Total Drug Medicare Standardized Payment Amount | 672.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 506 |
| Number Of Medicare Beneficiaries With Medical Services | 105 |
| Total Medical Submitted Charge Amount | 34141 |
| Total Medical Medicare Allowed Amount | 22715.26 |
| Total Medical Medicare Payment Amount | 17750.05 |
| Total Medical Medicare Standardized Payment Amount | 18721.38 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 29 |
| Number Of Beneficiaries Age 65 to 74 | 39 |
| Number Of Beneficiaries Age 75 to 84 | 26 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 57 |
| Number Of Male Beneficiaries | 48 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 77 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9488 |