| National Provider Identifier [NPI]: | 1699061499 |
| Last Name Of The Provider | TIAN |
| First Name Of The Provider | QI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 901 E 5TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WASHINGTON |
| Zip Code Of The Provider | 630903127 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 10 |
| Number Of Services | 411 |
| Number Of Medicare Beneficiaries | 211 |
| Total Submitted Charge Amount | 71558 |
| Total Medicare Allowed Amount | 39916.63 |
| Total Medicare Payment Amount | 31279.86 |
| Total Medicare Standardized Payment Amount | 32683.28 |
| 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 | 10 |
| Number Of Medical Services | 411 |
| Number Of Medicare Beneficiaries With Medical Services | 211 |
| Total Medical Submitted Charge Amount | 71558 |
| Total Medical Medicare Allowed Amount | 39916.63 |
| Total Medical Medicare Payment Amount | 31279.86 |
| Total Medical Medicare Standardized Payment Amount | 32683.28 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 55 |
| Number Of Beneficiaries Age 75 to 84 | 73 |
| Number Of Beneficiaries Age Greater 84 | 44 |
| Number Of Female Beneficiaries | 112 |
| Number Of Male Beneficiaries | 99 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 152 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 59 |
| Percent Of With Atrial Fibrillation | 31 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 57 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 43 |
| Percent Of With Depression | 48 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.8118 |