| National Provider Identifier [NPI]: | 1124033055 |
| Last Name Of The Provider | TANAKA |
| First Name Of The Provider | GUILLERMO |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M. D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 969 LAKELAND DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | JACKSON |
| Zip Code Of The Provider | 392164606 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 267 |
| Number Of Services | 7111 |
| Number Of Medicare Beneficiaries | 3799 |
| Total Submitted Charge Amount | 2476018.6 |
| Total Medicare Allowed Amount | 283941.54 |
| Total Medicare Payment Amount | 218430.78 |
| Total Medicare Standardized Payment Amount | 227507.81 |
| 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 | 267 |
| Number Of Medical Services | 7111 |
| Number Of Medicare Beneficiaries With Medical Services | 3799 |
| Total Medical Submitted Charge Amount | 2476018.6 |
| Total Medical Medicare Allowed Amount | 283941.54 |
| Total Medical Medicare Payment Amount | 218430.78 |
| Total Medical Medicare Standardized Payment Amount | 227507.81 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 861 |
| Number Of Beneficiaries Age 65 to 74 | 1268 |
| Number Of Beneficiaries Age 75 to 84 | 1060 |
| Number Of Beneficiaries Age Greater 84 | 610 |
| Number Of Female Beneficiaries | 2340 |
| Number Of Male Beneficiaries | 1459 |
| Number Of Non Hispanic White Beneficiaries | 2256 |
| Number Of Black or African American Beneficiaries | 1499 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2328 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1471 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.0951 |