| National Provider Identifier [NPI]: | 1487634713 |
| Last Name Of The Provider | CHIN |
| First Name Of The Provider | GLORIA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 929 N US HIGHWAY 441 |
| Street Address 2 Of The Provider | SUITE 401 |
| City Of The Provider | LADY LAKE |
| Zip Code Of The Provider | 321593001 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Plastic and Reconstructive Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 90 |
| Number Of Services | 9045 |
| Number Of Medicare Beneficiaries | 911 |
| Total Submitted Charge Amount | 779321.5 |
| Total Medicare Allowed Amount | 452615.18 |
| Total Medicare Payment Amount | 339226.99 |
| Total Medicare Standardized Payment Amount | 338929.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 5463 |
| Number Of Medicare Beneficiaries With Drug Services | 576 |
| Total Drug Submitted ChargeAmount | 200390.5 |
| Total Drug Medicare AllowedAmount | 125469.37 |
| Total Drug Medicare PaymentAmount | 97680.41 |
| Total Drug Medicare Standardized Payment Amount | 97680.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 85 |
| Number Of Medical Services | 3582 |
| Number Of Medicare Beneficiaries With Medical Services | 911 |
| Total Medical Submitted Charge Amount | 578931 |
| Total Medical Medicare Allowed Amount | 327145.81 |
| Total Medical Medicare Payment Amount | 241546.58 |
| Total Medical Medicare Standardized Payment Amount | 241248.96 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 488 |
| Number Of Beneficiaries Age 75 to 84 | 333 |
| Number Of Beneficiaries Age Greater 84 | 47 |
| Number Of Female Beneficiaries | 524 |
| Number Of Male Beneficiaries | 387 |
| Number Of Non Hispanic White Beneficiaries | 863 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 877 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 63 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0138 |