National Provider Identifier [NPI]: |
1497817746 |
Last Name Of The Provider |
CHAN |
First Name Of The Provider |
ERICK |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
795 EL CAMINO REAL |
Street Address 2 Of The Provider |
LEVEL 2, LEE BUILDING, PALO ALTO MEDICAL FOUNDATION |
City Of The Provider |
PALO ALTO |
Zip Code Of The Provider |
943012302 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
588 |
Number Of Medicare Beneficiaries |
291 |
Total Submitted Charge Amount |
629919.2 |
Total Medicare Allowed Amount |
100465.7 |
Total Medicare Payment Amount |
76231.65 |
Total Medicare Standardized Payment Amount |
67539.89 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
179 |
Number Of Beneficiaries Age 75 to 84 |
77 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
140 |
Number Of Male Beneficiaries |
151 |
Number Of Non Hispanic White Beneficiaries |
199 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
61 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
13 |
Number Of Beneficiaries With Medicare Only Entitlement |
259 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
7 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
6 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
4 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
41 |
Percent Of With Ischemic Heart Disease |
17 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
23 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9681 |