| National Provider Identifier [NPI]: | 1407872351 |
| Last Name Of The Provider | CHUA |
| First Name Of The Provider | SERAFIN |
| 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 | 2653 W OGDEN AVE |
| Street Address 2 Of The Provider | 3RD FLOOR |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606081647 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 1696 |
| Number Of Medicare Beneficiaries | 291 |
| Total Submitted Charge Amount | 164855 |
| Total Medicare Allowed Amount | 77849.3 |
| Total Medicare Payment Amount | 54476.17 |
| Total Medicare Standardized Payment Amount | 49112.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 688 |
| Number Of Medicare Beneficiaries With Drug Services | 84 |
| Total Drug Submitted ChargeAmount | 14448 |
| Total Drug Medicare AllowedAmount | 1225.9 |
| Total Drug Medicare PaymentAmount | 916.91 |
| Total Drug Medicare Standardized Payment Amount | 916.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 1008 |
| Number Of Medicare Beneficiaries With Medical Services | 291 |
| Total Medical Submitted Charge Amount | 150407 |
| Total Medical Medicare Allowed Amount | 76623.4 |
| Total Medical Medicare Payment Amount | 53559.26 |
| Total Medical Medicare Standardized Payment Amount | 48196.03 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 100 |
| Number Of Beneficiaries Age 65 to 74 | 119 |
| Number Of Beneficiaries Age 75 to 84 | 53 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 225 |
| Number Of Male Beneficiaries | 66 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 174 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 84 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 88 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 203 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 21 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.6127 |