| National Provider Identifier [NPI]: | 1942406756 |
| Last Name Of The Provider | CHAN |
| First Name Of The Provider | IAN |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 139 CENTRE ST PH 113 |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW YORK |
| Zip Code Of The Provider | 100134559 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 2138 |
| Number Of Medicare Beneficiaries | 261 |
| Total Submitted Charge Amount | 342563.48 |
| Total Medicare Allowed Amount | 195675.75 |
| Total Medicare Payment Amount | 152401.77 |
| Total Medicare Standardized Payment Amount | 134041.86 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 285 |
| Number Of Medicare Beneficiaries With Drug Services | 67 |
| Total Drug Submitted ChargeAmount | 28600.47 |
| Total Drug Medicare AllowedAmount | 12059.14 |
| Total Drug Medicare PaymentAmount | 9454.21 |
| Total Drug Medicare Standardized Payment Amount | 9454.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 1853 |
| Number Of Medicare Beneficiaries With Medical Services | 261 |
| Total Medical Submitted Charge Amount | 313963.01 |
| Total Medical Medicare Allowed Amount | 183616.61 |
| Total Medical Medicare Payment Amount | 142947.56 |
| Total Medical Medicare Standardized Payment Amount | 124587.65 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 87 |
| Number Of Beneficiaries Age 75 to 84 | 114 |
| Number Of Beneficiaries Age Greater 84 | 41 |
| Number Of Female Beneficiaries | 137 |
| Number Of Male Beneficiaries | 124 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | 243 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 48 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 213 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 7 |
| Percent Of With Diabetes | 61 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 22 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.604 |