| National Provider Identifier [NPI]: | 1871689794 |
| Last Name Of The Provider | CHAN |
| First Name Of The Provider | TERENCE |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3417 ENSIGN RD NE |
| Street Address 2 Of The Provider | |
| City Of The Provider | OLYMPIA |
| Zip Code Of The Provider | 985065064 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 176 |
| Number Of Services | 6746 |
| Number Of Medicare Beneficiaries | 3263 |
| Total Submitted Charge Amount | 515446.84 |
| Total Medicare Allowed Amount | 177172.36 |
| Total Medicare Payment Amount | 138288.17 |
| Total Medicare Standardized Payment Amount | 141939.34 |
| 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 | 176 |
| Number Of Medical Services | 6746 |
| Number Of Medicare Beneficiaries With Medical Services | 3263 |
| Total Medical Submitted Charge Amount | 515446.84 |
| Total Medical Medicare Allowed Amount | 177172.36 |
| Total Medical Medicare Payment Amount | 138288.17 |
| Total Medical Medicare Standardized Payment Amount | 141939.34 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 610 |
| Number Of Beneficiaries Age 65 to 74 | 1223 |
| Number Of Beneficiaries Age 75 to 84 | 942 |
| Number Of Beneficiaries Age Greater 84 | 488 |
| Number Of Female Beneficiaries | 2108 |
| Number Of Male Beneficiaries | 1155 |
| Number Of Non Hispanic White Beneficiaries | 3090 |
| Number Of Black or African American Beneficiaries | 13 |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | 71 |
| Number Of American Indian Alaska Native Beneficiaries | 45 |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2434 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 829 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2688 |