| National Provider Identifier [NPI]: | 1417064825 |
| Last Name Of The Provider | TANNOUS |
| First Name Of The Provider | MANHAL |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 250 S CRESCENT DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | MASON CITY |
| Zip Code Of The Provider | 504012926 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 1571 |
| Number Of Medicare Beneficiaries | 892 |
| Total Submitted Charge Amount | 1258637.25 |
| Total Medicare Allowed Amount | 255722.13 |
| Total Medicare Payment Amount | 197998.96 |
| Total Medicare Standardized Payment Amount | 220231.72 |
| 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 | 63 |
| Number Of Medical Services | 1571 |
| Number Of Medicare Beneficiaries With Medical Services | 892 |
| Total Medical Submitted Charge Amount | 1258637.25 |
| Total Medical Medicare Allowed Amount | 255722.13 |
| Total Medical Medicare Payment Amount | 197998.96 |
| Total Medical Medicare Standardized Payment Amount | 220231.72 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 106 |
| Number Of Beneficiaries Age 65 to 74 | 414 |
| Number Of Beneficiaries Age 75 to 84 | 283 |
| Number Of Beneficiaries Age Greater 84 | 89 |
| Number Of Female Beneficiaries | 495 |
| Number Of Male Beneficiaries | 397 |
| Number Of Non Hispanic White Beneficiaries | 866 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 765 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 127 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1205 |