| National Provider Identifier [NPI]: | 1235164468 |
| Last Name Of The Provider | TALLEY |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1710 GUNBARREL RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHATTANOOGA |
| Zip Code Of The Provider | 374213127 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 234 |
| Number Of Services | 5753 |
| Number Of Medicare Beneficiaries | 2708 |
| Total Submitted Charge Amount | 788904.25 |
| Total Medicare Allowed Amount | 171372.52 |
| Total Medicare Payment Amount | 128490.87 |
| Total Medicare Standardized Payment Amount | 137524.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 663 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 948.41 |
| Total Drug Medicare AllowedAmount | 349.9 |
| Total Drug Medicare PaymentAmount | 274.33 |
| Total Drug Medicare Standardized Payment Amount | 274.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 230 |
| Number Of Medical Services | 5090 |
| Number Of Medicare Beneficiaries With Medical Services | 2708 |
| Total Medical Submitted Charge Amount | 787955.84 |
| Total Medical Medicare Allowed Amount | 171022.62 |
| Total Medical Medicare Payment Amount | 128216.54 |
| Total Medical Medicare Standardized Payment Amount | 137249.89 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 702 |
| Number Of Beneficiaries Age 65 to 74 | 910 |
| Number Of Beneficiaries Age 75 to 84 | 725 |
| Number Of Beneficiaries Age Greater 84 | 371 |
| Number Of Female Beneficiaries | 1632 |
| Number Of Male Beneficiaries | 1076 |
| Number Of Non Hispanic White Beneficiaries | 2274 |
| Number Of Black or African American Beneficiaries | 388 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1752 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 956 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.8254 |