| National Provider Identifier [NPI]: | 1023091972 |
| Last Name Of The Provider | CHAN |
| First Name Of The Provider | ALEX |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3700 PARK EAST DRIVE |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | BEACHWOOD |
| Zip Code Of The Provider | 441224399 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 208 |
| Number Of Services | 16148 |
| Number Of Medicare Beneficiaries | 4241 |
| Total Submitted Charge Amount | 1003517.7 |
| Total Medicare Allowed Amount | 390690.65 |
| Total Medicare Payment Amount | 300178.14 |
| Total Medicare Standardized Payment Amount | 325692.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 9403 |
| Number Of Medicare Beneficiaries With Drug Services | 124 |
| Total Drug Submitted ChargeAmount | 10912 |
| Total Drug Medicare AllowedAmount | 2562.02 |
| Total Drug Medicare PaymentAmount | 1969.78 |
| Total Drug Medicare Standardized Payment Amount | 1969.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 206 |
| Number Of Medical Services | 6745 |
| Number Of Medicare Beneficiaries With Medical Services | 4241 |
| Total Medical Submitted Charge Amount | 992605.7 |
| Total Medical Medicare Allowed Amount | 388128.63 |
| Total Medical Medicare Payment Amount | 298208.36 |
| Total Medical Medicare Standardized Payment Amount | 323722.34 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 758 |
| Number Of Beneficiaries Age 65 to 74 | 1527 |
| Number Of Beneficiaries Age 75 to 84 | 1344 |
| Number Of Beneficiaries Age Greater 84 | 612 |
| Number Of Female Beneficiaries | 2423 |
| Number Of Male Beneficiaries | 1818 |
| Number Of Non Hispanic White Beneficiaries | 3572 |
| Number Of Black or African American Beneficiaries | 585 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 34 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3275 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 966 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.7426 |