| National Provider Identifier [NPI]: | 1518938810 |
| Last Name Of The Provider | TAN |
| First Name Of The Provider | JEANETTE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7806 GATEWAY BLVD E |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | EL PASO |
| Zip Code Of The Provider | 799151806 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 13842 |
| Number Of Medicare Beneficiaries | 1024 |
| Total Submitted Charge Amount | 2234747 |
| Total Medicare Allowed Amount | 924600.88 |
| Total Medicare Payment Amount | 709228.39 |
| Total Medicare Standardized Payment Amount | 601463.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 2332 |
| Number Of Medicare Beneficiaries With Drug Services | 240 |
| Total Drug Submitted ChargeAmount | 85854 |
| Total Drug Medicare AllowedAmount | 37490.62 |
| Total Drug Medicare PaymentAmount | 29442.63 |
| Total Drug Medicare Standardized Payment Amount | 29442.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 11510 |
| Number Of Medicare Beneficiaries With Medical Services | 1024 |
| Total Medical Submitted Charge Amount | 2148893 |
| Total Medical Medicare Allowed Amount | 887110.26 |
| Total Medical Medicare Payment Amount | 679785.76 |
| Total Medical Medicare Standardized Payment Amount | 572021.28 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 185 |
| Number Of Beneficiaries Age 65 to 74 | 317 |
| Number Of Beneficiaries Age 75 to 84 | 331 |
| Number Of Beneficiaries Age Greater 84 | 191 |
| Number Of Female Beneficiaries | 591 |
| Number Of Male Beneficiaries | 433 |
| Number Of Non Hispanic White Beneficiaries | 352 |
| Number Of Black or African American Beneficiaries | 37 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 609 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 623 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 401 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 31 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 53 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.7011 |