| National Provider Identifier [NPI]: | 1154326718 |
| Last Name Of The Provider | TAN |
| First Name Of The Provider | VALIANT |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 725 VOLVO PKWY |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | CHESAPEAKE |
| Zip Code Of The Provider | 233201602 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 153 |
| Number Of Services | 252167 |
| Number Of Medicare Beneficiaries | 1128 |
| Total Submitted Charge Amount | 12257782.59 |
| Total Medicare Allowed Amount | 3352311.78 |
| Total Medicare Payment Amount | 2597615.57 |
| Total Medicare Standardized Payment Amount | 2592530.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 82 |
| Number Of Drug Services | 237024 |
| Number Of Medicare Beneficiaries With Drug Services | 404 |
| Total Drug Submitted ChargeAmount | 10209805.59 |
| Total Drug Medicare AllowedAmount | 2787641.28 |
| Total Drug Medicare PaymentAmount | 2155278.14 |
| Total Drug Medicare Standardized Payment Amount | 2155278.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 71 |
| Number Of Medical Services | 15143 |
| Number Of Medicare Beneficiaries With Medical Services | 1128 |
| Total Medical Submitted Charge Amount | 2047977 |
| Total Medical Medicare Allowed Amount | 564670.5 |
| Total Medical Medicare Payment Amount | 442337.43 |
| Total Medical Medicare Standardized Payment Amount | 437252.11 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 130 |
| Number Of Beneficiaries Age 65 to 74 | 521 |
| Number Of Beneficiaries Age 75 to 84 | 358 |
| Number Of Beneficiaries Age Greater 84 | 119 |
| Number Of Female Beneficiaries | 690 |
| Number Of Male Beneficiaries | 438 |
| Number Of Non Hispanic White Beneficiaries | 766 |
| Number Of Black or African American Beneficiaries | 294 |
| Number Of AsianPacific Islander Beneficiaries | 27 |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 949 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 179 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 52 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.7811 |