| National Provider Identifier [NPI]: | 1184825879 |
| Last Name Of The Provider | TANK |
| First Name Of The Provider | NITI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 98 PARK WAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | EDISON |
| Zip Code Of The Provider | 088175332 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 207 |
| Number Of Services | 9214 |
| Number Of Medicare Beneficiaries | 4654 |
| Total Submitted Charge Amount | 1745755.9 |
| Total Medicare Allowed Amount | 309980.22 |
| Total Medicare Payment Amount | 233283.9 |
| Total Medicare Standardized Payment Amount | 225076.07 |
| 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 | 207 |
| Number Of Medical Services | 9214 |
| Number Of Medicare Beneficiaries With Medical Services | 4654 |
| Total Medical Submitted Charge Amount | 1745755.9 |
| Total Medical Medicare Allowed Amount | 309980.22 |
| Total Medical Medicare Payment Amount | 233283.9 |
| Total Medical Medicare Standardized Payment Amount | 225076.07 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 1037 |
| Number Of Beneficiaries Age 65 to 74 | 1443 |
| Number Of Beneficiaries Age 75 to 84 | 1290 |
| Number Of Beneficiaries Age Greater 84 | 884 |
| Number Of Female Beneficiaries | 2641 |
| Number Of Male Beneficiaries | 2013 |
| Number Of Non Hispanic White Beneficiaries | 3092 |
| Number Of Black or African American Beneficiaries | 1071 |
| Number Of AsianPacific Islander Beneficiaries | 64 |
| Number Of Hispanic Beneficiaries | 380 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 47 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3328 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1326 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.0359 |