| National Provider Identifier [NPI]: | 1417164476 |
| Last Name Of The Provider | CHAN |
| First Name Of The Provider | FARN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2280 OPITZ BLVD STE 220 |
| Street Address 2 Of The Provider | |
| City Of The Provider | WOODBRIDGE |
| Zip Code Of The Provider | 221913362 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 77 |
| Number Of Services | 12204 |
| Number Of Medicare Beneficiaries | 272 |
| Total Submitted Charge Amount | 869991.45 |
| Total Medicare Allowed Amount | 399128.3 |
| Total Medicare Payment Amount | 307371.24 |
| Total Medicare Standardized Payment Amount | 303811.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 39 |
| Number Of Drug Services | 9939 |
| Number Of Medicare Beneficiaries With Drug Services | 63 |
| Total Drug Submitted ChargeAmount | 452404.5 |
| Total Drug Medicare AllowedAmount | 189032.71 |
| Total Drug Medicare PaymentAmount | 147623.07 |
| Total Drug Medicare Standardized Payment Amount | 147623.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 2265 |
| Number Of Medicare Beneficiaries With Medical Services | 272 |
| Total Medical Submitted Charge Amount | 417586.95 |
| Total Medical Medicare Allowed Amount | 210095.59 |
| Total Medical Medicare Payment Amount | 159748.17 |
| Total Medical Medicare Standardized Payment Amount | 156188.41 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 46 |
| Number Of Beneficiaries Age 65 to 74 | 112 |
| Number Of Beneficiaries Age 75 to 84 | 83 |
| Number Of Beneficiaries Age Greater 84 | 31 |
| Number Of Female Beneficiaries | 159 |
| Number Of Male Beneficiaries | 113 |
| Number Of Non Hispanic White Beneficiaries | 149 |
| Number Of Black or African American Beneficiaries | 78 |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 197 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 75 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 29 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.2683 |