| National Provider Identifier [NPI]: | 1912987520 |
| Last Name Of The Provider | CHAN |
| First Name Of The Provider | PRINCE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7550 WEST VILLAGE CIRCLE |
| Street Address 2 Of The Provider | SUITE 1 |
| City Of The Provider | WICHITA |
| Zip Code Of The Provider | 67205 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hand Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 117 |
| Number Of Services | 4028.5 |
| Number Of Medicare Beneficiaries | 756 |
| Total Submitted Charge Amount | 1385482 |
| Total Medicare Allowed Amount | 352319.42 |
| Total Medicare Payment Amount | 260951.86 |
| Total Medicare Standardized Payment Amount | 277774.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 664.5 |
| Number Of Medicare Beneficiaries With Drug Services | 264 |
| Total Drug Submitted ChargeAmount | 2658 |
| Total Drug Medicare AllowedAmount | 1186.28 |
| Total Drug Medicare PaymentAmount | 885.36 |
| Total Drug Medicare Standardized Payment Amount | 885.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 116 |
| Number Of Medical Services | 3364 |
| Number Of Medicare Beneficiaries With Medical Services | 756 |
| Total Medical Submitted Charge Amount | 1382824 |
| Total Medical Medicare Allowed Amount | 351133.14 |
| Total Medical Medicare Payment Amount | 260066.5 |
| Total Medical Medicare Standardized Payment Amount | 276889.27 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 130 |
| Number Of Beneficiaries Age 65 to 74 | 372 |
| Number Of Beneficiaries Age 75 to 84 | 172 |
| Number Of Beneficiaries Age Greater 84 | 82 |
| Number Of Female Beneficiaries | 442 |
| Number Of Male Beneficiaries | 314 |
| Number Of Non Hispanic White Beneficiaries | 691 |
| Number Of Black or African American Beneficiaries | 27 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 680 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 76 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1312 |