| National Provider Identifier [NPI]: | 1467445080 |
| Last Name Of The Provider | DIAZ |
| First Name Of The Provider | TANYA |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 511 MEDICAL PLAZA DR |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | LEESBURG |
| Zip Code Of The Provider | 347487326 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 107 |
| Number Of Services | 9095 |
| Number Of Medicare Beneficiaries | 757 |
| Total Submitted Charge Amount | 619745.71 |
| Total Medicare Allowed Amount | 383987.1 |
| Total Medicare Payment Amount | 299089.86 |
| Total Medicare Standardized Payment Amount | 301942.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 963 |
| Number Of Medicare Beneficiaries With Drug Services | 253 |
| Total Drug Submitted ChargeAmount | 27864 |
| Total Drug Medicare AllowedAmount | 20702.5 |
| Total Drug Medicare PaymentAmount | 19926.55 |
| Total Drug Medicare Standardized Payment Amount | 19926.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 98 |
| Number Of Medical Services | 8132 |
| Number Of Medicare Beneficiaries With Medical Services | 757 |
| Total Medical Submitted Charge Amount | 591881.71 |
| Total Medical Medicare Allowed Amount | 363284.6 |
| Total Medical Medicare Payment Amount | 279163.31 |
| Total Medical Medicare Standardized Payment Amount | 282015.91 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 48 |
| Number Of Beneficiaries Age 65 to 74 | 387 |
| Number Of Beneficiaries Age 75 to 84 | 239 |
| Number Of Beneficiaries Age Greater 84 | 83 |
| Number Of Female Beneficiaries | 500 |
| Number Of Male Beneficiaries | 257 |
| Number Of Non Hispanic White Beneficiaries | 694 |
| Number Of Black or African American Beneficiaries | 20 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 674 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 83 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2235 |