| National Provider Identifier [NPI]: | 1730324245 |
| Last Name Of The Provider | LY |
| First Name Of The Provider | TAN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5922 CATTLEMEN LN STE 201 |
| Street Address 2 Of The Provider | |
| City Of The Provider | SARASOTA |
| Zip Code Of The Provider | 342326204 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 104 |
| Number Of Services | 2550 |
| Number Of Medicare Beneficiaries | 499 |
| Total Submitted Charge Amount | 2188771 |
| Total Medicare Allowed Amount | 435361.55 |
| Total Medicare Payment Amount | 333147.2 |
| Total Medicare Standardized Payment Amount | 297742.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 225 |
| Number Of Medicare Beneficiaries With Drug Services | 67 |
| Total Drug Submitted ChargeAmount | 2829 |
| Total Drug Medicare AllowedAmount | 631.69 |
| Total Drug Medicare PaymentAmount | 489.9 |
| Total Drug Medicare Standardized Payment Amount | 489.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 102 |
| Number Of Medical Services | 2325 |
| Number Of Medicare Beneficiaries With Medical Services | 499 |
| Total Medical Submitted Charge Amount | 2185942 |
| Total Medical Medicare Allowed Amount | 434729.86 |
| Total Medical Medicare Payment Amount | 332657.3 |
| Total Medical Medicare Standardized Payment Amount | 297252.36 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 49 |
| Number Of Beneficiaries Age 65 to 74 | 192 |
| Number Of Beneficiaries Age 75 to 84 | 172 |
| Number Of Beneficiaries Age Greater 84 | 86 |
| Number Of Female Beneficiaries | 290 |
| Number Of Male Beneficiaries | 209 |
| Number Of Non Hispanic White Beneficiaries | 481 |
| Number Of Black or African American Beneficiaries | |
| 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 | 443 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 56 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 69 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3105 |