National Provider Identifier [NPI]: |
1790750743 |
Last Name Of The Provider |
CHAN |
First Name Of The Provider |
STEVE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
660 N. DIAMOND BAR BLVD #118 |
Street Address 2 Of The Provider |
|
City Of The Provider |
DIAMOND BAR |
Zip Code Of The Provider |
917651034 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
4076 |
Number Of Medicare Beneficiaries |
314 |
Total Submitted Charge Amount |
508120.03 |
Total Medicare Allowed Amount |
434581.58 |
Total Medicare Payment Amount |
337828.72 |
Total Medicare Standardized Payment Amount |
313468.01 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
52 |
Number Of Medicare Beneficiaries With Drug Services |
47 |
Total Drug Submitted ChargeAmount |
1850.03 |
Total Drug Medicare AllowedAmount |
877.01 |
Total Drug Medicare PaymentAmount |
859.37 |
Total Drug Medicare Standardized Payment Amount |
859.37 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
27 |
Number Of Medical Services |
4024 |
Number Of Medicare Beneficiaries With Medical Services |
314 |
Total Medical Submitted Charge Amount |
506270 |
Total Medical Medicare Allowed Amount |
433704.57 |
Total Medical Medicare Payment Amount |
336969.35 |
Total Medical Medicare Standardized Payment Amount |
312608.64 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
84 |
Number Of Beneficiaries Age 75 to 84 |
124 |
Number Of Beneficiaries Age Greater 84 |
78 |
Number Of Female Beneficiaries |
172 |
Number Of Male Beneficiaries |
142 |
Number Of Non Hispanic White Beneficiaries |
99 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
172 |
Number Of Hispanic Beneficiaries |
26 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
134 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
180 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
39 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
20 |
Percent Of With Stroke |
22 |
Average HCC Risk Score Of Beneficiaries |
2.4531 |