| National Provider Identifier [NPI]: | 1851407787 |
| Last Name Of The Provider | CHAN |
| First Name Of The Provider | ROXANNE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 15332 ANTIOCH ST |
| Street Address 2 Of The Provider | #212 |
| City Of The Provider | PACIFIC PALISADES |
| Zip Code Of The Provider | 902723628 |
| 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 | 136 |
| Number Of Services | 5771 |
| Number Of Medicare Beneficiaries | 2302 |
| Total Submitted Charge Amount | 601884.21 |
| Total Medicare Allowed Amount | 161841.69 |
| Total Medicare Payment Amount | 117626.12 |
| Total Medicare Standardized Payment Amount | 111166.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 136 |
| Number Of Medical Services | 5771 |
| Number Of Medicare Beneficiaries With Medical Services | 2302 |
| Total Medical Submitted Charge Amount | 601884.21 |
| Total Medical Medicare Allowed Amount | 161841.69 |
| Total Medical Medicare Payment Amount | 117626.12 |
| Total Medical Medicare Standardized Payment Amount | 111166.65 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 306 |
| Number Of Beneficiaries Age 65 to 74 | 714 |
| Number Of Beneficiaries Age 75 to 84 | 752 |
| Number Of Beneficiaries Age Greater 84 | 530 |
| Number Of Female Beneficiaries | 1213 |
| Number Of Male Beneficiaries | 1089 |
| Number Of Non Hispanic White Beneficiaries | 675 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 1230 |
| Number Of Hispanic Beneficiaries | 320 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 40 |
| Number Of Beneficiaries With Medicare Only Entitlement | 554 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1748 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 34 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 56 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 58 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 67 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.5829 |