| National Provider Identifier [NPI]: | 1376534552 |
| Last Name Of The Provider | CHEN |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD PHD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 55 FRUIT ST |
| Street Address 2 Of The Provider | GRB 285 |
| City Of The Provider | BOSTON |
| Zip Code Of The Provider | 021142621 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 1568 |
| Number Of Medicare Beneficiaries | 387 |
| Total Submitted Charge Amount | 282195 |
| Total Medicare Allowed Amount | 49534.24 |
| Total Medicare Payment Amount | 37915.86 |
| Total Medicare Standardized Payment Amount | 36463.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1068 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 3852 |
| Total Drug Medicare AllowedAmount | 814.7 |
| Total Drug Medicare PaymentAmount | 612.46 |
| Total Drug Medicare Standardized Payment Amount | 612.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 500 |
| Number Of Medicare Beneficiaries With Medical Services | 387 |
| Total Medical Submitted Charge Amount | 278343 |
| Total Medical Medicare Allowed Amount | 48719.54 |
| Total Medical Medicare Payment Amount | 37303.4 |
| Total Medical Medicare Standardized Payment Amount | 35850.7 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 48 |
| Number Of Beneficiaries Age 65 to 74 | 150 |
| Number Of Beneficiaries Age 75 to 84 | 130 |
| Number Of Beneficiaries Age Greater 84 | 59 |
| Number Of Female Beneficiaries | 209 |
| Number Of Male Beneficiaries | 178 |
| Number Of Non Hispanic White Beneficiaries | 345 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 300 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 87 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 26 |
| Average HCC Risk Score Of Beneficiaries | 1.8564 |