| National Provider Identifier [NPI]: | 1174512032 |
| Last Name Of The Provider | TAM |
| First Name Of The Provider | MARVIN |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1125 E SOUTHERN AVE |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | MESA |
| Zip Code Of The Provider | 852045045 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 200 |
| Number Of Services | 18288 |
| Number Of Medicare Beneficiaries | 2993 |
| Total Submitted Charge Amount | 1576388.4 |
| Total Medicare Allowed Amount | 428466.83 |
| Total Medicare Payment Amount | 322594.86 |
| Total Medicare Standardized Payment Amount | 331931.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 14009 |
| Number Of Medicare Beneficiaries With Drug Services | 177 |
| Total Drug Submitted ChargeAmount | 21628.24 |
| Total Drug Medicare AllowedAmount | 4450.18 |
| Total Drug Medicare PaymentAmount | 3464.56 |
| Total Drug Medicare Standardized Payment Amount | 3464.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 194 |
| Number Of Medical Services | 4279 |
| Number Of Medicare Beneficiaries With Medical Services | 2993 |
| Total Medical Submitted Charge Amount | 1554760.16 |
| Total Medical Medicare Allowed Amount | 424016.65 |
| Total Medical Medicare Payment Amount | 319130.3 |
| Total Medical Medicare Standardized Payment Amount | 328466.6 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 347 |
| Number Of Beneficiaries Age 65 to 74 | 1240 |
| Number Of Beneficiaries Age 75 to 84 | 970 |
| Number Of Beneficiaries Age Greater 84 | 436 |
| Number Of Female Beneficiaries | 1775 |
| Number Of Male Beneficiaries | 1218 |
| Number Of Non Hispanic White Beneficiaries | 2585 |
| Number Of Black or African American Beneficiaries | 86 |
| Number Of AsianPacific Islander Beneficiaries | 41 |
| Number Of Hispanic Beneficiaries | 175 |
| Number Of American Indian Alaska Native Beneficiaries | 68 |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2610 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 383 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.6595 |