| National Provider Identifier [NPI]: | 1245229772 |
| Last Name Of The Provider | TAN |
| First Name Of The Provider | WINSTON |
| 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 | 4500 SAN PABLO RD S |
| Street Address 2 Of The Provider | |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322241865 |
| 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 | 94 |
| Number Of Services | 50525 |
| Number Of Medicare Beneficiaries | 545 |
| Total Submitted Charge Amount | 1289299.6 |
| Total Medicare Allowed Amount | 1141252.44 |
| Total Medicare Payment Amount | 873375.48 |
| Total Medicare Standardized Payment Amount | 880292.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 56 |
| Number Of Drug Services | 47762 |
| Number Of Medicare Beneficiaries With Drug Services | 145 |
| Total Drug Submitted ChargeAmount | 1056932.93 |
| Total Drug Medicare AllowedAmount | 946061.24 |
| Total Drug Medicare PaymentAmount | 725346.77 |
| Total Drug Medicare Standardized Payment Amount | 725346.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 2763 |
| Number Of Medicare Beneficiaries With Medical Services | 543 |
| Total Medical Submitted Charge Amount | 232366.67 |
| Total Medical Medicare Allowed Amount | 195191.2 |
| Total Medical Medicare Payment Amount | 148028.71 |
| Total Medical Medicare Standardized Payment Amount | 154946.18 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 252 |
| Number Of Beneficiaries Age 75 to 84 | 197 |
| Number Of Beneficiaries Age Greater 84 | 70 |
| Number Of Female Beneficiaries | 178 |
| Number Of Male Beneficiaries | 367 |
| Number Of Non Hispanic White Beneficiaries | 479 |
| Number Of Black or African American Beneficiaries | 47 |
| 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 | 524 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 21 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 61 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.8549 |