| National Provider Identifier [NPI]: | 1073598827 |
| Last Name Of The Provider | TANKANOW |
| First Name Of The Provider | LARRY |
| 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 | 30117 SCHOENHERR RD |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | WARREN |
| Zip Code Of The Provider | 480886851 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 4041 |
| Number Of Medicare Beneficiaries | 1055 |
| Total Submitted Charge Amount | 495914.14 |
| Total Medicare Allowed Amount | 359389.06 |
| Total Medicare Payment Amount | 275244.06 |
| Total Medicare Standardized Payment Amount | 267699.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 298 |
| Number Of Medicare Beneficiaries With Drug Services | 85 |
| Total Drug Submitted ChargeAmount | 4105.62 |
| Total Drug Medicare AllowedAmount | 2830.45 |
| Total Drug Medicare PaymentAmount | 2479.92 |
| Total Drug Medicare Standardized Payment Amount | 2479.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 3743 |
| Number Of Medicare Beneficiaries With Medical Services | 1055 |
| Total Medical Submitted Charge Amount | 491808.52 |
| Total Medical Medicare Allowed Amount | 356558.61 |
| Total Medical Medicare Payment Amount | 272764.14 |
| Total Medical Medicare Standardized Payment Amount | 265219.27 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 142 |
| Number Of Beneficiaries Age 65 to 74 | 326 |
| Number Of Beneficiaries Age 75 to 84 | 349 |
| Number Of Beneficiaries Age Greater 84 | 238 |
| Number Of Female Beneficiaries | 599 |
| Number Of Male Beneficiaries | 456 |
| Number Of Non Hispanic White Beneficiaries | 897 |
| Number Of Black or African American Beneficiaries | 118 |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| 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 | 775 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 280 |
| Percent Of With Atrial Fibrillation | 32 |
| Percent Of With Alzheimers Disease or Dementia | 31 |
| Percent Of With Asthma | 27 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 66 |
| Percent Of With Chronic Kidney Disease | 58 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 75 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 56 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.6878 |