| National Provider Identifier [NPI]: | 1144234519 |
| Last Name Of The Provider | PARK |
| First Name Of The Provider | CHRIS |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 18895 COLIMA RD |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | ROWLAND HEIGHTS |
| Zip Code Of The Provider | 917482978 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 14 |
| Number Of Services | 3287 |
| Number Of Medicare Beneficiaries | 1070 |
| Total Submitted Charge Amount | 265060 |
| Total Medicare Allowed Amount | 260892.32 |
| Total Medicare Payment Amount | 204068.39 |
| Total Medicare Standardized Payment Amount | 211785.69 |
| 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 | 14 |
| Number Of Medical Services | 3287 |
| Number Of Medicare Beneficiaries With Medical Services | 1070 |
| Total Medical Submitted Charge Amount | 265060 |
| Total Medical Medicare Allowed Amount | 260892.32 |
| Total Medical Medicare Payment Amount | 204068.39 |
| Total Medical Medicare Standardized Payment Amount | 211785.69 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 20 |
| Number Of Beneficiaries Age 65 to 74 | 372 |
| Number Of Beneficiaries Age 75 to 84 | 500 |
| Number Of Beneficiaries Age Greater 84 | 178 |
| Number Of Female Beneficiaries | 698 |
| Number Of Male Beneficiaries | 372 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 993 |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 104 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 966 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 64 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 28 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 66 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4069 |