| National Provider Identifier [NPI]: | 1194821488 |
| Last Name Of The Provider | CHAN |
| First Name Of The Provider | KARENCE |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | ONE HOAG DRIVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEWPORT BEACH |
| Zip Code Of The Provider | 92660 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 189 |
| Number Of Services | 7501 |
| Number Of Medicare Beneficiaries | 3062 |
| Total Submitted Charge Amount | 1160389.16 |
| Total Medicare Allowed Amount | 274233.95 |
| Total Medicare Payment Amount | 207872.97 |
| Total Medicare Standardized Payment Amount | 190362.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 3160 |
| Number Of Medicare Beneficiaries With Drug Services | 65 |
| Total Drug Submitted ChargeAmount | 9440 |
| Total Drug Medicare AllowedAmount | 1510.33 |
| Total Drug Medicare PaymentAmount | 1184.16 |
| Total Drug Medicare Standardized Payment Amount | 1184.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 186 |
| Number Of Medical Services | 4341 |
| Number Of Medicare Beneficiaries With Medical Services | 3062 |
| Total Medical Submitted Charge Amount | 1150949.16 |
| Total Medical Medicare Allowed Amount | 272723.62 |
| Total Medical Medicare Payment Amount | 206688.81 |
| Total Medical Medicare Standardized Payment Amount | 189178.14 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 172 |
| Number Of Beneficiaries Age 65 to 74 | 1218 |
| Number Of Beneficiaries Age 75 to 84 | 1060 |
| Number Of Beneficiaries Age Greater 84 | 612 |
| Number Of Female Beneficiaries | 1755 |
| Number Of Male Beneficiaries | 1307 |
| Number Of Non Hispanic White Beneficiaries | 2589 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 262 |
| Number Of Hispanic Beneficiaries | 102 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 78 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2624 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 438 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5989 |