| National Provider Identifier [NPI]: | 1821082389 |
| Last Name Of The Provider | CHEN |
| First Name Of The Provider | JACK |
| 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 | 960 JOHNSON FERRY RD NE |
| Street Address 2 Of The Provider | SUITE 500 |
| City Of The Provider | ATLANTA |
| Zip Code Of The Provider | 303421631 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 3156 |
| Number Of Medicare Beneficiaries | 918 |
| Total Submitted Charge Amount | 888321 |
| Total Medicare Allowed Amount | 302799.95 |
| Total Medicare Payment Amount | 231525.45 |
| Total Medicare Standardized Payment Amount | 231260.72 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 312 |
| Number Of Medicare Beneficiaries With Drug Services | 81 |
| Total Drug Submitted ChargeAmount | 38520 |
| Total Drug Medicare AllowedAmount | 14103.58 |
| Total Drug Medicare PaymentAmount | 10979.59 |
| Total Drug Medicare Standardized Payment Amount | 10979.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 2844 |
| Number Of Medicare Beneficiaries With Medical Services | 918 |
| Total Medical Submitted Charge Amount | 849801 |
| Total Medical Medicare Allowed Amount | 288696.37 |
| Total Medical Medicare Payment Amount | 220545.86 |
| Total Medical Medicare Standardized Payment Amount | 220281.13 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 75 |
| Number Of Beneficiaries Age 65 to 74 | 399 |
| Number Of Beneficiaries Age 75 to 84 | 314 |
| Number Of Beneficiaries Age Greater 84 | 130 |
| Number Of Female Beneficiaries | 455 |
| Number Of Male Beneficiaries | 463 |
| Number Of Non Hispanic White Beneficiaries | 659 |
| Number Of Black or African American Beneficiaries | 115 |
| Number Of AsianPacific Islander Beneficiaries | 103 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 746 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 172 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.682 |