| National Provider Identifier [NPI]: | 1578520995 |
| Last Name Of The Provider | TAN |
| First Name Of The Provider | NEHEMIAH |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 102 W KENWOOD AVE |
| Street Address 2 Of The Provider | STE 110 |
| City Of The Provider | DECATUR |
| Zip Code Of The Provider | 625264300 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 32677 |
| Number Of Medicare Beneficiaries | 807 |
| Total Submitted Charge Amount | 1529790.62 |
| Total Medicare Allowed Amount | 968562.39 |
| Total Medicare Payment Amount | 747117.17 |
| Total Medicare Standardized Payment Amount | 757288.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 29805 |
| Number Of Medicare Beneficiaries With Drug Services | 154 |
| Total Drug Submitted ChargeAmount | 1067129.62 |
| Total Drug Medicare AllowedAmount | 737132.29 |
| Total Drug Medicare PaymentAmount | 576084.1 |
| Total Drug Medicare Standardized Payment Amount | 576084.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 2872 |
| Number Of Medicare Beneficiaries With Medical Services | 807 |
| Total Medical Submitted Charge Amount | 462661 |
| Total Medical Medicare Allowed Amount | 231430.1 |
| Total Medical Medicare Payment Amount | 171033.07 |
| Total Medical Medicare Standardized Payment Amount | 181204.55 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 124 |
| Number Of Beneficiaries Age 65 to 74 | 368 |
| Number Of Beneficiaries Age 75 to 84 | 242 |
| Number Of Beneficiaries Age Greater 84 | 73 |
| Number Of Female Beneficiaries | 616 |
| Number Of Male Beneficiaries | 191 |
| Number Of Non Hispanic White Beneficiaries | 732 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 674 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 133 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 74 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.2487 |