| National Provider Identifier [NPI]: | 1164474615 |
| Last Name Of The Provider | BLANCO |
| First Name Of The Provider | RAFAEL |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M. D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3402 W DR MARTIN LUTHER KING JR BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TAMPA |
| Zip Code Of The Provider | 336076214 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 186 |
| Number Of Services | 169922 |
| Number Of Medicare Beneficiaries | 895 |
| Total Submitted Charge Amount | 4926990 |
| Total Medicare Allowed Amount | 1826167.03 |
| Total Medicare Payment Amount | 1428424.32 |
| Total Medicare Standardized Payment Amount | 1425486.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 83 |
| Number Of Drug Services | 158085 |
| Number Of Medicare Beneficiaries With Drug Services | 322 |
| Total Drug Submitted ChargeAmount | 3439894 |
| Total Drug Medicare AllowedAmount | 1293620.32 |
| Total Drug Medicare PaymentAmount | 1003977.6 |
| Total Drug Medicare Standardized Payment Amount | 1003977.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 103 |
| Number Of Medical Services | 11837 |
| Number Of Medicare Beneficiaries With Medical Services | 895 |
| Total Medical Submitted Charge Amount | 1487096 |
| Total Medical Medicare Allowed Amount | 532546.71 |
| Total Medical Medicare Payment Amount | 424446.72 |
| Total Medical Medicare Standardized Payment Amount | 421508.73 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 102 |
| Number Of Beneficiaries Age 65 to 74 | 341 |
| Number Of Beneficiaries Age 75 to 84 | 296 |
| Number Of Beneficiaries Age Greater 84 | 156 |
| Number Of Female Beneficiaries | 570 |
| Number Of Male Beneficiaries | 325 |
| Number Of Non Hispanic White Beneficiaries | 504 |
| Number Of Black or African American Beneficiaries | 62 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 315 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 614 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 281 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 46 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 2.0587 |