| National Provider Identifier [NPI]: | 1982766382 |
| Last Name Of The Provider | TAN |
| First Name Of The Provider | TERENCE |
| 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 | 3301 BEECHWOOD AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | LYNWOOD |
| Zip Code Of The Provider | 902623301 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pediatric Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 419.5 |
| Number Of Medicare Beneficiaries | 69 |
| Total Submitted Charge Amount | 45820 |
| Total Medicare Allowed Amount | 34315.76 |
| Total Medicare Payment Amount | 25726.43 |
| Total Medicare Standardized Payment Amount | 23628.72 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 31.5 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 1200 |
| Total Drug Medicare AllowedAmount | 648.95 |
| Total Drug Medicare PaymentAmount | 635.71 |
| Total Drug Medicare Standardized Payment Amount | 635.71 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 388 |
| Number Of Medicare Beneficiaries With Medical Services | 69 |
| Total Medical Submitted Charge Amount | 44620 |
| Total Medical Medicare Allowed Amount | 33666.81 |
| Total Medical Medicare Payment Amount | 25090.72 |
| Total Medical Medicare Standardized Payment Amount | 22993.01 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 27 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 47 |
| Number Of Male Beneficiaries | 22 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 14 |
| 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 | 12 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 57 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2927 |