| National Provider Identifier [NPI]: | 1518129956 |
| Last Name Of The Provider | CHAN |
| First Name Of The Provider | ANNIE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 608 STANTON L YOUNG BLVD |
| Street Address 2 Of The Provider | DEAN MCGEE EYE INSTITUTE |
| City Of The Provider | OKLAHOMA CITY |
| Zip Code Of The Provider | 731045014 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 954 |
| Number Of Medicare Beneficiaries | 341 |
| Total Submitted Charge Amount | 277726 |
| Total Medicare Allowed Amount | 121098.28 |
| Total Medicare Payment Amount | 91030.12 |
| Total Medicare Standardized Payment Amount | 96044.55 |
| 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 | 49 |
| Number Of Medical Services | 954 |
| Number Of Medicare Beneficiaries With Medical Services | 341 |
| Total Medical Submitted Charge Amount | 277726 |
| Total Medical Medicare Allowed Amount | 121098.28 |
| Total Medical Medicare Payment Amount | 91030.12 |
| Total Medical Medicare Standardized Payment Amount | 96044.55 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 100 |
| Number Of Beneficiaries Age 65 to 74 | 148 |
| Number Of Beneficiaries Age 75 to 84 | 70 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 202 |
| Number Of Male Beneficiaries | 139 |
| Number Of Non Hispanic White Beneficiaries | 148 |
| Number Of Black or African American Beneficiaries | 23 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 157 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 201 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 140 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.6844 |