| National Provider Identifier [NPI]: | 1073802526 |
| Last Name Of The Provider | CHIU |
| First Name Of The Provider | ALBERT |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2601 FIELDCREST DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | KAUKAUNA |
| Zip Code Of The Provider | 541304523 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 106 |
| Number Of Medicare Beneficiaries | 43 |
| Total Submitted Charge Amount | 12309 |
| Total Medicare Allowed Amount | 5152.09 |
| Total Medicare Payment Amount | 4246.41 |
| Total Medicare Standardized Payment Amount | 4581.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 14 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 455 |
| Total Drug Medicare AllowedAmount | 331.38 |
| Total Drug Medicare PaymentAmount | 324.04 |
| Total Drug Medicare Standardized Payment Amount | 324.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 92 |
| Number Of Medicare Beneficiaries With Medical Services | 43 |
| Total Medical Submitted Charge Amount | 11854 |
| Total Medical Medicare Allowed Amount | 4820.71 |
| Total Medical Medicare Payment Amount | 3922.37 |
| Total Medical Medicare Standardized Payment Amount | 4257.08 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 16 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 23 |
| Number Of Male Beneficiaries | 20 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 27 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | 30 |
| 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 | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 40 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0202 |