| National Provider Identifier [NPI]: | 1548373210 |
| Last Name Of The Provider | TARK |
| First Name Of The Provider | MARVIN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 400 TOWER ROAD |
| Street Address 2 Of The Provider | SUITE 350 |
| City Of The Provider | MARIETTA |
| Zip Code Of The Provider | 300609415 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Anesthesiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 15605 |
| Number Of Medicare Beneficiaries | 1002 |
| Total Submitted Charge Amount | 1227136.04 |
| Total Medicare Allowed Amount | 535920.64 |
| Total Medicare Payment Amount | 455155.61 |
| Total Medicare Standardized Payment Amount | 397188.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 92 |
| Number Of Medicare Beneficiaries With Drug Services | 56 |
| Total Drug Submitted ChargeAmount | 3430 |
| Total Drug Medicare AllowedAmount | 927.63 |
| Total Drug Medicare PaymentAmount | 714.92 |
| Total Drug Medicare Standardized Payment Amount | 714.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 15513 |
| Number Of Medicare Beneficiaries With Medical Services | 1002 |
| Total Medical Submitted Charge Amount | 1223706.04 |
| Total Medical Medicare Allowed Amount | 534993.01 |
| Total Medical Medicare Payment Amount | 454440.69 |
| Total Medical Medicare Standardized Payment Amount | 396473.56 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 375 |
| Number Of Beneficiaries Age 65 to 74 | 362 |
| Number Of Beneficiaries Age 75 to 84 | 193 |
| Number Of Beneficiaries Age Greater 84 | 72 |
| Number Of Female Beneficiaries | 688 |
| Number Of Male Beneficiaries | 314 |
| Number Of Non Hispanic White Beneficiaries | 855 |
| Number Of Black or African American Beneficiaries | 113 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 743 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 259 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.8831 |