| National Provider Identifier [NPI]: | 1982921094 |
| Last Name Of The Provider | TAN |
| First Name Of The Provider | MARION |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1400 S COULTER ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | AMARILLO |
| Zip Code Of The Provider | 791061786 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 1115 |
| Number Of Medicare Beneficiaries | 423 |
| Total Submitted Charge Amount | 165550.96 |
| Total Medicare Allowed Amount | 68881.01 |
| Total Medicare Payment Amount | 52900.75 |
| Total Medicare Standardized Payment Amount | 55467.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 140 |
| Number Of Medicare Beneficiaries With Drug Services | 74 |
| Total Drug Submitted ChargeAmount | 4365 |
| Total Drug Medicare AllowedAmount | 985.85 |
| Total Drug Medicare PaymentAmount | 947.41 |
| Total Drug Medicare Standardized Payment Amount | 947.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 975 |
| Number Of Medicare Beneficiaries With Medical Services | 423 |
| Total Medical Submitted Charge Amount | 161185.96 |
| Total Medical Medicare Allowed Amount | 67895.16 |
| Total Medical Medicare Payment Amount | 51953.34 |
| Total Medical Medicare Standardized Payment Amount | 54519.65 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 78 |
| Number Of Beneficiaries Age 65 to 74 | 115 |
| Number Of Beneficiaries Age 75 to 84 | 144 |
| Number Of Beneficiaries Age Greater 84 | 86 |
| Number Of Female Beneficiaries | 289 |
| Number Of Male Beneficiaries | 134 |
| Number Of Non Hispanic White Beneficiaries | 341 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 42 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 300 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 123 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3597 |