| National Provider Identifier [NPI]: | 1477697084 |
| Last Name Of The Provider | TAMANAHA |
| First Name Of The Provider | PHILIP |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 275 HOSPITAL DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | UKIAH |
| Zip Code Of The Provider | 954824531 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 206 |
| Number Of Services | 5896 |
| Number Of Medicare Beneficiaries | 2940 |
| Total Submitted Charge Amount | 1467750.53 |
| Total Medicare Allowed Amount | 193932.07 |
| Total Medicare Payment Amount | 143470.85 |
| Total Medicare Standardized Payment Amount | 141166.55 |
| 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 | 206 |
| Number Of Medical Services | 5896 |
| Number Of Medicare Beneficiaries With Medical Services | 2940 |
| Total Medical Submitted Charge Amount | 1467750.53 |
| Total Medical Medicare Allowed Amount | 193932.07 |
| Total Medical Medicare Payment Amount | 143470.85 |
| Total Medical Medicare Standardized Payment Amount | 141166.55 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 543 |
| Number Of Beneficiaries Age 65 to 74 | 1271 |
| Number Of Beneficiaries Age 75 to 84 | 778 |
| Number Of Beneficiaries Age Greater 84 | 348 |
| Number Of Female Beneficiaries | 1841 |
| Number Of Male Beneficiaries | 1099 |
| Number Of Non Hispanic White Beneficiaries | 2519 |
| Number Of Black or African American Beneficiaries | 13 |
| Number Of AsianPacific Islander Beneficiaries | 27 |
| Number Of Hispanic Beneficiaries | 213 |
| Number Of American Indian Alaska Native Beneficiaries | 129 |
| Number Of Beneficiaries With Race Not Else where Classified | 39 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2018 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 922 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2753 |