| National Provider Identifier [NPI]: | 1306869482 |
| Last Name Of The Provider | CHAO |
| First Name Of The Provider | JULIE |
| Middle Initial Of The Provider | Y |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10351 DAWSONS CREEK BLVD |
| Street Address 2 Of The Provider | SUITE C |
| City Of The Provider | FORT WAYNE |
| Zip Code Of The Provider | 468251904 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Anesthesiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 2922 |
| Number Of Medicare Beneficiaries | 192 |
| Total Submitted Charge Amount | 391259.53 |
| Total Medicare Allowed Amount | 125388.82 |
| Total Medicare Payment Amount | 91550.17 |
| Total Medicare Standardized Payment Amount | 99545.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 411 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 4110 |
| Total Drug Medicare AllowedAmount | 731.94 |
| Total Drug Medicare PaymentAmount | 534.98 |
| Total Drug Medicare Standardized Payment Amount | 534.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 2511 |
| Number Of Medicare Beneficiaries With Medical Services | 192 |
| Total Medical Submitted Charge Amount | 387149.53 |
| Total Medical Medicare Allowed Amount | 124656.88 |
| Total Medical Medicare Payment Amount | 91015.19 |
| Total Medical Medicare Standardized Payment Amount | 99010.23 |
| Average Age Of Beneficiaries | 51 |
| Number Of Beneficiaries Age Less65 | 166 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 117 |
| Number Of Male Beneficiaries | 75 |
| Number Of Non Hispanic White Beneficiaries | 158 |
| 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 | 42 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 150 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 49 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 66 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4008 |