National Provider Identifier [NPI]: |
1508961319 |
Last Name Of The Provider |
TAHN |
First Name Of The Provider |
CARL |
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 |
107 LONGWOOD AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROCKLEDGE |
Zip Code Of The Provider |
329552827 |
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 |
122 |
Number Of Services |
99576 |
Number Of Medicare Beneficiaries |
1077 |
Total Submitted Charge Amount |
5066981 |
Total Medicare Allowed Amount |
1347838.98 |
Total Medicare Payment Amount |
1062491.63 |
Total Medicare Standardized Payment Amount |
1059104.08 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
65 |
Number Of Drug Services |
90268 |
Number Of Medicare Beneficiaries With Drug Services |
218 |
Total Drug Submitted ChargeAmount |
4139860 |
Total Drug Medicare AllowedAmount |
1055601.36 |
Total Drug Medicare PaymentAmount |
827076.49 |
Total Drug Medicare Standardized Payment Amount |
827076.49 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
57 |
Number Of Medical Services |
9308 |
Number Of Medicare Beneficiaries With Medical Services |
1077 |
Total Medical Submitted Charge Amount |
927121 |
Total Medical Medicare Allowed Amount |
292237.62 |
Total Medical Medicare Payment Amount |
235415.14 |
Total Medical Medicare Standardized Payment Amount |
232027.59 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
118 |
Number Of Beneficiaries Age 65 to 74 |
391 |
Number Of Beneficiaries Age 75 to 84 |
401 |
Number Of Beneficiaries Age Greater 84 |
167 |
Number Of Female Beneficiaries |
621 |
Number Of Male Beneficiaries |
456 |
Number Of Non Hispanic White Beneficiaries |
919 |
Number Of Black or African American Beneficiaries |
99 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
38 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
921 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
156 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
40 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.9183 |