| National Provider Identifier [NPI]: | 1801810668 |
| Last Name Of The Provider | TAN |
| First Name Of The Provider | SHARON |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 41 N MAIN ST |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | WEST HARTFORD |
| Zip Code Of The Provider | 061071972 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Geriatric Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 913 |
| Number Of Medicare Beneficiaries | 238 |
| Total Submitted Charge Amount | 140043 |
| Total Medicare Allowed Amount | 72134.05 |
| Total Medicare Payment Amount | 53454.03 |
| Total Medicare Standardized Payment Amount | 49896.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 60 |
| Number Of Medicare Beneficiaries With Drug Services | 59 |
| Total Drug Submitted ChargeAmount | 2588 |
| Total Drug Medicare AllowedAmount | 1498.68 |
| Total Drug Medicare PaymentAmount | 1360.18 |
| Total Drug Medicare Standardized Payment Amount | 1360.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 853 |
| Number Of Medicare Beneficiaries With Medical Services | 238 |
| Total Medical Submitted Charge Amount | 137455 |
| Total Medical Medicare Allowed Amount | 70635.37 |
| Total Medical Medicare Payment Amount | 52093.85 |
| Total Medical Medicare Standardized Payment Amount | 48536.47 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 108 |
| Number Of Beneficiaries Age 75 to 84 | 90 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 184 |
| Number Of Male Beneficiaries | 54 |
| Number Of Non Hispanic White Beneficiaries | 206 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 217 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 21 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0141 |